[Laser conization guided by endocervical staining with methylene blue].
The authors report their experience of the use of a vital stain--methylene blue--as a surgical guide in laser cervical conization for CIN2-CIN3/CIS. During the period 1 October 1991-31 December 1992 a total of 40 laser cervical conizations were performed under local anesthesia using a CO2 laser connected to a microhandpiece and colposcope in patients with exo-endocervical lesions which were histologically positive for CIN2-CIN3/CIS. In 33/40 patients an aqueous solution of 1% methylene blue was introduced preoperatively in the endocervix using a cotton-wool bud with consequent impregnation of the pseudoglandular crypts: laser biopsy was performed along the guidelines of the stain itself. This enabled the direction of resection to be varied: in 3 patients due to an anomalous and eccentric direction of cervical canal; in 10 patients to remove glandular structures surrounding or underneath lesions; in 8 patients following pseudoglandular section to carry out deep vaporization (3 patients) or correct cutting edges (5 patients). The apex and edges of the cone were always intact. Fourteen patients completed a 12-month follow-up and a further 6 were followed up for 9 months; only 1/14 patients (with AIDS) showed recidivation after 1 year. In the authors' experience the use of a vital stain as a guide during laser cervical cone biopsy is an easily used method which ensures the greatest possible respect for healthy cervical structures, also in order to preserve fertility in young patients.
Divisione di Oncologia Chirurgica Ginecologica, Centro di Riferimento Oncologico, Aviano, PN.
F
F
Sopracordevole
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E
Campagnutta
A
A
Parin
C
C
Scarabelli
D000328:Adult; D000772:Anesthesia, Local; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery*; D003127:Colposcopy; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008751:Methylene Blue; D008875:Middle Aged; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000601:surgery
D008751:Methylene Blue
Conizzazione laser guidata mediante colorazione endocervicale con blu di metilene.