<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412020000900586</article-id>
<article-id pub-id-type="doi">10.24245/gom.v88i9.4317</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Importancia de los márgenes quirúrgicos afectados en la conización uterina cervical]]></article-title>
<article-title xml:lang="en"><![CDATA[Importance of surgical margins affected in cervical uterine conization]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santa María-Ortiz]]></surname>
<given-names><![CDATA[Johana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Álvarez-Silvares]]></surname>
<given-names><![CDATA[Esther]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bermúdez-González]]></surname>
<given-names><![CDATA[Mónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lavandeira]]></surname>
<given-names><![CDATA[Sandra García]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pato Mosquera]]></surname>
<given-names><![CDATA[Mónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Couso Cambeiro]]></surname>
<given-names><![CDATA[Bárbara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Complexo Hospitalario Universitario de Ourense Servicio de Obstetricia y Ginecología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Complexo Hospitalario Universitario de Ourense Servicio de Obstetricia y Ginecología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Complexo Hospitalario Universitario de Ourense Servicio de Obstetricia y Ginecología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<volume>88</volume>
<numero>9</numero>
<fpage>586</fpage>
<lpage>597</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412020000900586&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412020000900586&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412020000900586&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  OBJETIVO: Determinar la asociación entre los márgenes afectados con la persistencia-recurrencia de neoplasia intraepitelial cervical, persistencia del virus del papiloma humano y las reintervenciones.  MATERIALES Y MÉTODOS:  Estudio de casos y controles anidado en una cohorte retrospectiva del Complexo Hospitalario Universitario de Ourense (enero 2010-octubre 2017). Criterio de inclusión: mujeres con al menos una revisión postintervención. Criterios de exclusión: mujeres sin evidencia de displasia de alto grado en la pieza de conización y a las que no se dio seguimiento. Variables de estudio: edad, tabaquismo, preservativo, anticonceptivos orales, vacunación contra VPH, persistencia-recurrencia de NIC y de VPH y reintervención. Se realizaron pruebas parame&#769;tricas y no parame&#769;tricas entre las variables.  RESULTADOS: La cohorte se integró con 248 mujeres, de éstas 81 (32.6%) tuvieron afectación de los márgenes quirúrgicos en la conización. La inmunosupresión, el tabaquismo y la anticoncepción oral fueron las asociaciones más frecuentes en los márgenes afectados. El uso de preservativo y la vacunación contra VPH fueron significativamente más frecuentes en los márgenes libres. Los márgenes afectados reportaron mayor persistencia de VPH (50 vs 23.9%; OR 3.17 (1.90-5.26), p &lt; 0.001), enfermedad persistente-recurrente (47.2 vs 22.5%; OR 3.07 (1.84-5.12), p &lt; 0.001) y reintervenciones (40.2 vs 15.4%; OR 3.679 (2.094-6.463), p &lt; 0.028). El margen más afectado fue, en orden descendente, endocervical (55.6%), exocervical (25%) y ambos (19.4%).  CONCLUSIONES: El margen afectado confiere un riesgo importante en la evolución de la infección por VPH y la recurrencia de la enfermedad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  OBJECTIVE: To determine the association between affected margins with persistence-recurrence of cervical intraepithelial neoplasia, persistence of human papillomavirus and re-interventions.  MATERIALS AND METHODS:  Study of cases and controls nested in a retrospective cohort of the Complexo Hospitalario Universitario de Ourense (January 2010-October 2017). Inclusion criteria: women with at least one post-intervention check-up. Exclusion criteria: women without evidence of high-grade dysplasia in the conization piece and who were not followed up. Study variables: age, smoking, condom, oral contraceptives, HPV vaccination, persistence-recurrence of CIN and HPV, and re-operation. Parametric and non-parametric tests were performed among the variables.  RESULTS:  The cohort consisted of 248 women, 81 of whom (32.6%) had affected surgical margins on conization. Immunosuppression, smoking and oral contraception were the most frequent associations in affected margins. Condom use and HPV vaccination were significantly more frequent in free margins. Affected margins reported greater persistence of HPV (50 vs 23.9%; OR 3.17 (1.90-5.26), p &lt; 0.001), persistent-recurrent disease (47.2 vs 22.5%; OR 3.07 (1.84-5.12), p &lt; 0.001), and reinterventions (40.2 vs 15.4%; OR 3.679 (2.094-6.463), p &lt; 0.028). The most affected margin was, in descending order, endocervical (55.6%), exocervical (25%) and both (19.4%).  CONCLUSIONS:  The affected margin confers a significant risk in the evolution of HPV infection and disease recurrence.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Neoplasia intraepitelial cervical]]></kwd>
<kwd lng="es"><![CDATA[márgenes quirúrgicos]]></kwd>
<kwd lng="es"><![CDATA[virus del papiloma humano]]></kwd>
<kwd lng="es"><![CDATA[conización]]></kwd>
<kwd lng="es"><![CDATA[anticonceptivos orales]]></kwd>
<kwd lng="es"><![CDATA[uso de condón]]></kwd>
<kwd lng="es"><![CDATA[vacuna contra VPH]]></kwd>
<kwd lng="es"><![CDATA[infección por VPH]]></kwd>
<kwd lng="en"><![CDATA[Cervical intraepithelial neoplasia]]></kwd>
<kwd lng="en"><![CDATA[Surgical Margins]]></kwd>
<kwd lng="en"><![CDATA[Human Papillomavirus]]></kwd>
<kwd lng="en"><![CDATA[Conization]]></kwd>
<kwd lng="en"><![CDATA[Oral contraception]]></kwd>
<kwd lng="en"><![CDATA[Condom use]]></kwd>
<kwd lng="en"><![CDATA[HPV Vaccination]]></kwd>
<kwd lng="en"><![CDATA[HPV Infection]]></kwd>
</kwd-group>
</article-meta>
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