METHOD FOR TREATMENT AND DIAGNOSTIC RADIO-SURGICAL EXPOSURE OF UTERINE CERVIX AT SUSPECTED MALIGNANT DAMAGE AND TREATMENT TACTICS SELECTION

摘要

FIELD: medicine.;SUBSTANCE: uterine tissues are exposed to radio waves by stages. At the first stage, radio-wave cervix excision is performed using Surgitron device loop electrode, in the "Incision and Coagulation" mode, with a capacity of 5-8 units. The pathologically altered exocervix zone is removed within healthy tissues. At the second stage, radio-wave conization of the cervix is performed using the Surgitron device electrode-sail, in the "Incision and Coagulation" mode, with a capacity of 4-7 units, for which a cone-shaped excision of the endocervix is performed, with the capture of the middle and lower third of the cervical canal, removing the preparation as a single block. At the third stage, curettage of the removed cervical canal bed is performed. The choice of tactics for cervical cancer treatment involves histological examination of the material. In the absence of pathological changes at resection edges and detection of: CIN I, CIN II, CIN III Ca in situ, cervical cancer IA1st, regardless of the presence or absence of high carcinogenic risk human papillomavirus (HCR HPV), patient observation is prescribed. If cervical cancer IIA2 or more is detected, regardless of the presence or absence of HCR HPV, further surgical and/or radiotherapy is prescribed.;EFFECT: possibility to obtain a pathological focus in a single block of biomaterial for each structural part of the cervix with intact resection edges for morphological verification of the malignant process allows to preserve the cervical canal architectonics.;3 cl, 2 ex