Therapeutic Effect of High Frequency Loop Electrosurgical Excision Procedure Combined with Hysteroscopy in the Treatment of High Grade Cervical Intraepithelial Neoplasia
To investigate the effect of high-frequency loop electrosurgical excision procedure (LEEP) combined with hysteroscopy and simple cervical LEEP in the treatment of high-grade cervical intraepithelial neoplasia and its effect on recurrence. One hundred patients with high-grade intraepithelial neoplasia diagnosed by colposcopy in boths hospitals from January 2017 to June 2018 were enrolled. The patients were divided into observation group and control group according to random number table. The observation group was treated with hysteroscopy combined with cervical LEEP. The control group was treated with simple cervical LEEP. The operation duration, volume of intraoperative blood loss, the bleeding time of postoperative and postoperative recovery time were compared. The positive rate of postoperative margin, the recurrence rate and cervical adhesion rate at 6 months after operation were recorded. COX regression analysis was used to investigate the risk factors affecting postoperative recurrence. Results: there were no significant differences in the operation duration, volume of intraoperative blood loss, the bleeding time of postoperative, and postoperative recovery time between the two groups (P>0.05). The rate of postoperative positive margin was observed in the observation group (10.00% vs 32.00%). The recurrence rate at 6 months after surgery (6.00% vs 22.00%) was lower than that of the control group, and the difference was statistically significant (P <0.05). Analysis of correlation factors affecting recurrence showed that HPV infection, postoperative positive margin, and whether to use hysteroscopy for assistance were the associated factor affecting postoperative recurrence (P <0.05); COX regression analysis showed that HPV was positive (HR=1.311, 95%CI =1.053~1.988) and postoperative margin was positive (HR=1.429, 95%CI=1.028~1.764) were independent risk factors for postoperative recurrence (P <0.05). Hysteroscopic assisted (HR=-0.319, 95%CI =-0.211~0.967) was a protective factor for reducing recurrence rate (P <0.05). Cervical LEEP combined with hysteroscopy can reduce the positive margin rate of high-grade cervical intraepithelial neoplasia and reduce the recurrence rate. Hysteroscopy is an important protective factor to reduce recurrence.