Prognostički i terapijski značaj rezidualnog tumorskog tkiva u konizatu grlića materice. (Serbian).

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    • Alternate Title:
      Prognostic and therapeutic implication of residual tumorous tissue in cervix conizate. (English)
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    • Abstract:
      Background/Aim. Conization is an excisive technique used for both diagnostic and therapeutic purposes. If conizate margines do not show any pathologic changes (negative findings) it is also the only therapeutic measure which should be applied. In case of conizate margins affected by the disease (positive findings), it is necessary not only to assess various parameters but also to decide on a further therapeutic approach. The aim of this study was to determine the incidence of positive findings and its impact on a further optimal therapeutic approach choice. Methods. The data for analyses were retrospectively acquired through an insight into the medical records of the female patients who had undergone conization in the Institute for Gynecology and Obstetrics, Clinical Center of Serbia, within a period from 1995 to 2000. Histopathologic analyses of the bioptic and cervical conizate and reconizate samples were performed in the same institute. The acquired data were analyzed and statistically processed. Results. Within the above mentioned period, a total of 823 conizations were done. In 76 patients, positive findings were determined. The acquired data analysis revealed positive findings decrease during this period, yet with no statistical significance. Higher statistically significant incidence of positive findings, however, was revealed in the patients over 40 years of age. Also, a statistically significantly higher incidence of positive findings was revealed in the apex as compared with other localizations. During the period observed, there was the raise of the number of patients only followed up after the conization without reconization. Also evident was decreasing in the number of histerectomies followed by increasing in the number of reconizations, as the method for reintervention. The most common cause of histerectomy was the apex positive findings with no statistical significance, while of reconization it was positive finding on lateral conizate margins with statistical significance. The association of the apical conizate positive finding with that in the curettements in all the cases was in correlation with positive findings at reintervention. Conclusion. According to the results obtained by analyzing and statistical processing of the acquired data, it could be concluded that reconization does represent a more suitable reintervention in patients with positive conizate findings as compared to histerectomy. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Uvod/Cilj. Konizacija predstavlja ekscizionu tehniku koja se može primeniti u dijagnostičke i terapijske svrhe. Ukoliko su ivice konizata bez patoloških promena (negativan nalaz), konizacija predstavlja ujedno i jedinu terapijsku meru koju je potrebno primeniti. Ukoliko su ivice konizata zahvaćene bolešću (pozitivan nalaz) potrebno je uz analizu brojnih parametara opredeliti se za dalji terapijski pristup. Cilj ovog rada bio je utvrđivanje učestalosti pozitivnog nalaza i njegove važnosti u pogledu određivanja daljeg optimalnog terapijskog pristupa. Metode. Podaci potrebni za navedenu analizu prikupljeni su retrospektivno uvidom u medicinsku dokumentaciju bolesnica kod kojih je u Institutu za ginekologiju i akušerstvo Kliničkog centra Srbije u periodu od 1995. do 2000. godine urađena konizacija. Patohistološka analiza uzoraka dobijenih biopsijom kao i dela grlića odstranjenog konizacijom i rekonizovanjem rađena je u Odeljenju za patologiju Instituta za ginekologiju i akušerstvo. Prikupljeni podaci su analizirani i statistički obrađeni. Rezultati. U navedenom periodu urađene su 823 konizacije. Kod 76 bolesnica ustanovljen je pozitivan nalaz. Analizom prikupljenih podataka ustanovljen je pad broja pozitivnih nalaza tokom navedenog perioda bez statističke značajnosti. Veća učestalost pozitivnog nalaza, statistički značajna, ustanovljena je kod bolesnica starijih od 40 godina. Takođe, statistički značajno veća zastupljenost pozitivnih nalaza ustanovljena je na apeksu u odnosu na ostale lokalizacije. Tokom posmatranog perioda došlo je do povećanja broja bolesnica koje su nakon konizacije samo praćene bez reintervencije. Evidentno je i smanjenje broja histerektomija uz povećanje broja rekonizacija kao metoda reintervencija. Najčešći razlog za histerektomiju bio je pozitivan nalaz na apeksu, bez statističke značajnosti, a za rekonizaciju pozitivan nalaz na lateralnim ivicama konizata uz statističku značajnost. Udruženost pozitivnog nalaza na apeksu konizata i u kiretmanu u svim slučajevima je korelisao sa pozitivnim nalazom pri reintervenciji. Zaključak. Na osnovu rezultata dobijenih analizom i statističkom obradom prikupljenih podataka može se zaključiti da rekoniranje predstavlja adekvatniji vid reintervencije kod bolesnica sa pozitivnim nalazom konizata u odnosu na histerektomiju. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal of Serbia is the property of Military Medical Academy INI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)