cervical conization

Cervical conization is a procedure for obstetrics and gynecology to remove the cervix, that is, a part of the cervical tissue is cut from the outer to the inside in a conical shape. On the one hand, it is for pathological examination, to diagnose the lesion of the cervix; on the other hand, it is also a treatment for resection of the lesion. Treatment of diseases: cervical precancerous lesions, chronic cervicitis, cervical cancer Indication 1) Cervical scraping cytology has repeatedly found malignant cells, no abnormalities in colposcopy, cervical biopsy or segmental diagnosis of scraping neck can be further diagnosed by cervical conization. 2) Cervical biopsy has been diagnosed as carcinoma in situ, or early infiltration under the microscope. In order to determine the scope of surgery, cervical conization can be performed first, cervical tissue is cut for further pathological examination, the degree of lesion is determined, and the choice of surgical scope is guided. . 3) Suspected of cervical adenocarcinoma. 4) Patients with chronic cervicitis who have been treated conservatively and have poor results can be treated with cervical conization. Contraindications 1, acute reproductive tract infections, sexually transmitted diseases, cervical invasive cancer, genital malformations. 2, there are blood diseases, severe bleeding tendency. Preoperative preparation 1. It is best to choose surgery within 3 to 7 days after menstruation to reduce bleeding and reduce the chance of infection. 2. Because surgery may have more bleeding, blood type, blood routine and clotting time should be tested before surgery, except for bleeding diseases. 3. Preoperative examination except vaginitis can be performed. Pay attention to the cleansing of the vulva to avoid postoperative infection. Surgical procedure 1. Routine disinfection of the vulva, vagina and cervix, and disinfecting towels. The vaginal retractor exposes the cervix, and the compound iodine solution is applied to the entire cervix to define the extent of the lesion. Use a rat tooth clamp to clamp the iodine iodine coloring area and gently pull it down. A metal catheter is inserted into the bladder to determine the boundary of the lower edge of the bladder. 0.3 to 0.5 cm outside the cervical lesion, use a scalpel to make a circular incision in the vertical direction. 2. Tilt inward from 30 ° to 40 °, and gradually make a conical cut to the deep part of the cervix. 3. Note that the tip of the cone faces the inner mouth of the cervix, and the direction should not be skewed, so that the neck tissue is completely conically cut. 4. The general cone bottom width is 2 to 3 cm, and the cone height is about 2.5 cm, but it should not exceed the inner mouth of the cervix. If there is bleeding point in the cervical wound, it can be tied with 3-0 gut or iron to stop bleeding, stuffed with gauze, and taken out after 24h. 5. Cervical shaping and suturing. complication 1. Bleeding: more common. The predilection site is about 6 o'clock in the posterior lip of the cervix. A small amount of bleeding can be used to stop the bleeding with a large cotton swab or to disperse the laser beam to > 2mm, burn the hemorrhage and surrounding, and make the blood vessels coagulate; if there is more bleeding, it can be blocked with vaginal tampon or gauze, and taken out after 24 hours. 2. Postoperative pelvic infection: manifested as lower abdominal pain, cervical greenish black, secretions with odor, anal examination of uterine tenderness, local or systemic anti-inflammatory treatment.