抄録
It has been reported that the incidence of advanced cancer of the uterine cervix is decreasing due to the enforcement and popularity of cancer screening clinics. On the other hand, cervical intraepithelial neoplasia such as dysplasia and carcinoma in situ (CIS) have been noticeably increasing particularly among the young generation in the child-bearing age and therefore a need for conservative surgery of the uterus is in order. We performed conservative operations on patients with CIN and uterine cervical cancer using CO and Nd YAG laser treatments over the last six years. Patients who received laser therapy included 229 who received laser vaporization and 389 who received laser conization. Among these patients, the pathological diagnosis for 55 who received laser conization revealed microinvasive or invasive squamous cell carcinoma. Among the 10 patients with surgical margin remaining positive after conization or with deep stromal invasion by pathological examination, additional treatment consisting of hysterectomy and/or radiotherapy were performed. In those with microinvasive carcinoma who wanted to preserve their uterus, a cure with laser conization was achieved in 97.2%(35/36). There was only one recurrence noted among these patients and this was the case wherein enough lesion could not be excised and post operative pathological examination revealed positive margin. This said patient underwent laser conization during pregnancy at 18 weeks age of gestation and three years thereafter, she was found to have CIS for which she underwent REconization.
The above results suggest that laser conization can be applicable for the treatment of cervical microinvasive carcinoma accompanied by long term follow up and strict pathological diagnosis. Nevertheless, however, more cases would be appropriate to statistically confirm this possibility
