A technique of "limited" cone biopsy of the cervix under local anaesthesia - abstract

ABSTRACT

One hundred and fifteen biopsies of the cervix were performed by a new technique which can be described as "limited cone biopsy" used for the evaluation of the abnormal "Pap" smear. Patients were selected from those attending the Jamaica Cancer Society Screening Clinic for carcinoma of the cervix. The criteria for cone biopsy were (1) a history of repeated pap smear, (2) cases with colposcopic biopsies demonstrating a significant degree of dysplasia, and (3) colposcopic examination showing the squamo-columnar junction to be high up in the cervical canal. The new surgical technique "limits" the depth of excised tissue to 4 mm. This limitation, aided by special instruments, avoids troublesome haemorrhage and allows the procedure to be performed under local anaesthesia. It restricts hospital stay to two days. The study showed the following (1) that intravenous Pethidine and Valium provided adequate analgesia for all but seven cases, (2) blood loss at operation was minimal, exceeding 20 ml in only 3 cases, (3) 97 per cent of the patients were fit to be discharged after 32 hours in hospital, (4) the tissue samples were adequate for full histological study in all but three cases and (5) the pathology reports on the specimens which showed the following results (shown in table). It is concluded that the "limited" cone biopsy carries less morbidity than the conventional technique. The use of local anaesthesia and the short hospital stay recommended it highly for developing countries with scarce medical and financial resources (AU)