Lésions précancéreuses du col de l’utérus : Contribution de leur prise en charge par l’électro conisation à l’anse diathermique pour les pays à faible plateau technique médico-chirurgical

Abstract

Introduction : Cervical cancer is a potentially preventable disease through primary prevention, which involves prevention of sexually transmitted infections (STIs) and HPV vaccination, and secondary prevention, which involves diagnosis and early treatment of precancerous lesions. The aim of our study was to show that electroresection or loop electrosurgical excision procedure (ECAD) is a simple, reproducible method for the treatment of high-grade precancerous lesions of the uterine cervix.

Methods : This was a retrospective, non-randomised, descriptive, observational chartbased study conducted from January 2016 to December 2019 in the Obstetrics and Gynaecology Department of the Hôpital Privé de L'Ouest Parisien. All genitally active
women seen for gynaecology-obstetrics consultations were included

Results : 167 patients out of the 1268 FCVs performed had a pathological smear and were referred for colposcopy + biopsies, 13.17%. Biopsies represented less than 2% (1.98%) of all smears performed during the study period. Nearly half (49.10%) of the
biopsies referred by colposcopy were not precancerous lesions. These lesions included metaplasia in 34.73% of abnormal smears (58 cases) and chronic cervicitis in 24 cases (14.37%). Slightly more than 50% of the pathological smears (85) were precancerous lesions, broken down into low-grade CIN lesions (69), 41.14%, and high-grade CIN2-3
lesions (13) known as precancerous, 7.78% of the biopsies which underwent electroconization. 3 cases of cancer, 1.79%, essentially 2 adenocarcinomas of the uterine cervix and squamous cell carcinoma.

Conclusion : The practice of electro-resection (ERAD) of high-grade cervical lesions will considerably reduce the incidence of invasive cervical cancer, with its heavy, mutilating treatments. These treatments are sometimes prohibitively expensive for populations with very limited resources. Screening for cervical cancer would significantly reduce.