Patient's question:
Medical history: In August 2010, a check-up at the cancer hospital revealed chronic cervical inflammation at (1 o'clock, 6 o'clock, 10 o'clock) positions, with (6 o'clock, 10 o'clock) areas showing squamous epithelium with CIN1. I have had long-term cervical erosion.Treatment history and outcomes: No treatment has been administered yet. The diagnosis was just made.
Desired assistance: I had a cervical biopsy that showed CIN1 with cervical inflammation, and the doctor suggested removing half of my uterus. I am 44 years old and do not want children. Is surgical treatment advisable? Will there be a recurrence after surgery? What precautions should I take after the surgery?
Doctor's answer:
LEEP procedure on the cervix, try to perform a larger and deeper LEEP to ensure complete excision of the lesion.Scope: Intraoperative iodine staining to clearly define the lesion margins, with a 0.5 cm margin outside the lesion as the excisional margin. The depth should be at least 1.5 cm or more (doctors are aware of this).
The purpose of LEEP: To send the excised tissue for pathology. First, to determine the extent of the lesion, such as whether there are more severe lesions like carcinoma in situ or invasive cancer. Second, to check if the margins are clear.
If the pathology of the LEEP excised tissue shows no carcinoma in situ or cancer, and the margins are clear, then it can be considered cured.
If the excised tissue has more severe lesions, further surgery may be needed, such as hysterectomy (for carcinoma in situ) or radical hysterectomy (for invasive cancer).
It is not advisable to directly choose hysterectomy, because if the pathology after a hysterectomy shows invasive cancer, the next step in surgery would be impossible.
In summary, the purpose of LEEP is both diagnostic and therapeutic, and it cannot be skipped.