%0 Journal Article
%T Avalia£ż£żo da conduta conservadora na les£żo intraepitelial cervical de alto grau
%A Uchimura
%A Nelson Shozo
%A Uchimura
%A Taqueco Teruya
%A Martins
%A Jo£żo Paulo de Oliveira Branco
%A Assakawa
%A Fernando
%A Uchimura
%A Liza Yurie Teruya
%J Revista de Sa¨²de P¨²blica
%D 2012
%I Universidade de S?o Paulo
%R 10.1590/S0034-89102012005000024
%X objective: to assess the association between conservative management of high-grade cervical squamous intraepithelial lesions and recurrence rates and age groups. methods: cross-sectional, retrospective, analytical observational study of 509 women (aged 15 to 76) with abnormal pap smears attending a public reference center in the city of maring¨˘, southern brazil, from 1996 to 2006. data was collected from medical records, and the variables definitive diagnosis, type of treatment provided, occurrence of high-grade cervical squamous intraepithelial lesions and recurrence were studied. pearson's chi-square test and fisher's exact test were used in the statistical analyses. results: there were 168 cases of cervical high-grade cervical squamous intraepithelial lesions, of these, 31 were treated with cold-knife conization, 104 loop electrosurgical excision procedure, 9 hysterectomy and 24 conservative treatment (i.e., clinical and cytological follow-up or cervical electrocoagulation). a total of 8 (33.3%) women receiving conservative and 10 (6.9%) receiving non-conservative management had recurrent disease and this difference was statistically significant (p=0.0009), pr = 4.8 (95%ci 2.11;10.93). three (30.0%) women among those undergoing clinical and cytological follow-up and five 5 (35.7%) among those submitted to cervical electrocoagulation had recurrent disease within three years, but the difference was not significant (p=0.5611). recurrent rates in those younger and older than 30 were 13.8% (7 women) and 12.2% (11 women) (p = 0.9955). conclusions: age is not a predictor of disease recurrence. conservative treatment is only recommended in exceptional situations due to its high recurrence rates. careful cytological and colposcopic follow-up is required for three years when most recurrences occur.
%K cervix uteri [anatomy & histology]
%K uterine cervical neoplasms [therapy]
%K cervical intraepithelial neoplasia [therapy]
%K conization
%K electrocoagulation
%K cross-sectional studies.
%U http://www.scielosp.org/scielo.php?script=sci_abstract&pid=S0034-89102012000300008&lng=en&nrm=iso&tlng=en