Комплексна реабілітація пацієнток репродуктивного віку з передраковою патологією шийки матки після органозберігальних хірургічних втручань

A.I. Rybin

doi:10.18370/2309-4117.2021.60.91-94

Authors

A.I. Rybin Odessa National Medical University, Odessa, Ukraine https://orcid.org/0000-0002-1145-6690

DOI:

https://doi.org/10.18370/2309-4117.2021.60.91-94

Keywords:

cervical dysplasia, cervical epithelial neoplasia, treatment, rehabilitation

Abstract

The frequency of cervical dysplasia (cervical neoplasia) in the population is up to 5%, and in the structure of cervical diseases – 17–20%. Malignant transformation of the multilayered squamous epithelium is observed in almost 30% of patients with cervical dysplasia. The main surgical method of treatment of these conditions is diathermoconization of the cervix. But quite often patients have complaints in the late postoperative period. Comprehensive rehabilitation of patients of reproductive age with precancerous pathology of the cervix should include early restoration of sexual, reproductive and social functions of women.
Research objective: to study the clinical effectiveness of the drug Femiclean (dequalinium chloride) in the comprehensive rehabilitation of patients with precancerous pathology of the cervix after organ-sparing surgery.
Materials and methods. The first (main) group included 25 patients who, on the background of traditional treatment (broad diathermoconization of the cervix) for 6 days before and 12 days after treatment were treated with vaginal suppositories once a day Femiclean. The second (control) group consisted of 25 patients who underwent traditional treatment (broad diathermoconization of the cervix) with iodine-containing vaginal suppositories.
Results. In patients of reproductive age with precancerous pathology of the cervix, who applied the developed concept of management in the postoperative period, the recurrence rate was probably lower; the epithelialization time was significantly higher than in women of the control group. The epithelialization time of the cervix in patients who used Femiclean vaginally in the pre- and postoperative period was 7.8 days faster compared to women who used standard vaginal drugs. The drug of domestic production Femiclean, according to our data, is well tolerated by patients and does not cause side effects.
Conclusions. The developed complex rehabilitation of reproductive aged patients with precancerous pathology of the cervix after organ-sparing surgery has shown high clinical efficiency in comparison with traditional treatment this pathology.

Author Biography

A.I. Rybin, Odessa National Medical University, Odessa

MD, associate professor, highest category oncohematologist, Department of Radiation Diagnostics, Therapy and Oncology

References

Bokhman, Y.V. Lectures on gynecological oncology. M.: LLC Medical Information Agency, 2017. 304 p.
Gasparyan, S.A., Ovchinnikova, O.S. “Optimization of antiviral therapy with inosine pranobex for initial lesions of HPV-associated diseases of the cervix.” Obstetrics and Gynecology 9 (2015): 94–7.
Jemal, A., Vineis, P., Bray, F., et al. Atlas of Oncology. Second edition. Atlanta, Georgia: American Cancer Society, 2019.
Novik, V.I. “Epidemiology of cervical cancer, risk factors, screening.” Practical gynecological oncology: Selected lectures. Ed. by W.F. Urmancheeva, S.A. Tyulyandina, V.M. Moiseenko. Saint Petersburg: TOMM Center (2018): 101–15.
Prilepskaya, V.N., Nazarova, N.M., Mzareula, G.M., et al. “HPV-associated diseases of the cervix – new in diagnosis.” Obstetrics and Gynecology 9 (2019): 20–6.
de Abreu, A.L., Malaguti, N., Souza, R.P., et al. “Association of human papillomavirus, Neisseria gonorrhoeae and Chlamydia trachomatis co-infections on the risk of high-grade squamous intraepithelial cervical lesion.” Am J Cancer Res 6.6 (2020): 1371–83.
Rybin, A. “Quality of life of patients with ovarian cancer of the third stage using differentiated treatment.” Eureka: Health Sciences 5.11 (2017): 37–43.
Bassal, R., Schejter, E., Bachar, R., et al. “Risk Factors for Cervical Cancer and CIN3 in Jewish Women in Israel – Two Case Control Studies.” Asian Pac J Cancer Prev 17.4 (2016): 2067–73.
Boldrini, N.T., Freitas, L.B., Coutinho, A.R., et al. “High-grade cervical lesions among women attending a reference clinic in Brazil: associated factors and comparison among screening methods.” PLoS One 9.7 (2019): e102169.
Castanon, A., Landy R., Sasieni, P. “By how much could screening by primary human papillomavirus testing reduce cervical cancer incidence in England?” J Med Screen 24.2 (2017): 110–2. DOI: 10.1177/0969141316654197.
Cancer in Ukraine 2018–2019. Bulletin of the national cancer registry of Ukraine. Kyiv (2020), 80 р.
Global cancer observatory. Available from: [http://gco.iarc.fr], 2020.
Lew, J.B., Simms, K., Smith, M., et al. “Effectiveness Modelling and Economic Evaluation of Primary HPV Screening for Cervical Cancer Prevention in New Zealand.” PLoS One 11.5 (2019): e0151619. DOI: 10.1371/journal.pone.0151619
Li, W., Wang, D.Z., Shen, C.F., et al. Incidence trends of cervical cancer in Tianjin, 2007–2013. 37.5 (2016): 699–701. 10.3760/cma.j.issn.0254-6450.2016.05.023
Lindstrom, A.K., Hellberg, D. “Immunohistochemical LRIG3 expression in cervical intraepithelial neoplasia and invasive squamous cell cervical cancer: association with expression of tumor markers, hormones, high-risk HPV-infection, smoking and patient outcome.” Eur J Histochem 58.2 (2014): 2227.
Liu, Z.C., Liu, W.D., Liu, Y.H., et al. “Multiple Sexual Partners as a Potential Independent Risk Factor for Cervical Cancer: a Meta-analysis of Epidemiological Studies.” Asian Pac J Cancer Prev 16.9 (2015): 3893–900.
Louvanto, K., Syrjаnen, K.J., Rintala, M.A., et al. “Human papillomavirus and predictors of cervical intraepithelial neoplasia among young mothers in a prospective follow-up study.” Acta Obstet Gynecol Scand 90.2 (2014): 167–73.
Luhn, P., Walker, J., Schiffman, M., et al. “The role of co-factors in the progression from human papillomavirus infection to cervical cancer.” Gynecol Oncol 128.2 (2013): 265–70.
Matsumoto, K., Yoshikawa, H. “Human papillomavirus infection and the risk of cervical cancer in Japan.” J Obstet Gynaecol Re 39.1 (2013): 7–17.
McCann, M.F., Irwin, D.E., Walton, L.A., et al. “Nicotine and cotinine in the cervical mucus of smokers, passive smokers, and nonsmokers.” Cancer Epidemiol Biomarkers Prev 1.2 (1992): 125–9.
Monsonego, J., Zerat, L., Syrjanen, K., et al. “Prevalence of type-specific human papillomavirus infection among women in France: Implications for screening, vaccination, and a future generation of multivalent HPV vaccines.” Vaccine 30.35 (2012): 5215–21.
Ports, K.A., Reddy, D.M., Rameshbabu, A. “Barriers and facilitators to HPV vaccination: perspectives from Malawian women.” Women Health 53.6 (2013): 630–45. DOI: 10.1080/03630242.2013.809046
Ribeiro, A.A., Costa, M.C., Alves, R.R., et al. “HPV infection and cervical neoplasia: associated risk factors.” Infect Agent Cancer 10 (2015): 16.
Roura, E., Castellsague, X., Pawlita, M., et al. “Smoking as a major risk factor for cervical cancer and precancer: results from the EPIC cohort.” Int J Cancer 135.2 (2014): 453–66.
Rybin, A.I. “Modern look to the risk factors and prevention of cervical cancer.” Journal of education, health and sport 10.8 (2020): 230–48.
Rybin, A.I., Rybina, I.P. “Quality of life problems in gynecological cancer patients.” Journal of education, health and sport 10.6 (2020): 321–33.
Yörük, S., Açıkgöz, A., Ergör, G. “Determination of knowledge levels, attitude and behaviors of female university students concerning cervical cancer, human papiloma virus and its vaccine.” BMC Womens Health 16 (2016): 51–5.