Electrosurgical loop excision/conisation for cervical intraepithelial neoplasia in an algorithm that excludes punch biopsy--a study of 210 cases

Chirurgia (Bucur). 2009 May-Jun;104(3):295-301.

Abstract

This study aims to evaluate the use of LLETZ/conisation in an algorithm that excludes the colposcopically guided biopsy.

Material and methods: The study was carried out on 210 patients with LLETZ/conisation, performed in our service in 2 years. They were selected by pap smear, colposcopy, HPV genotyping, without punch biopsy.

Results: The pathological results on the excision specimen showed: benign lesion 10%, CIN 1/condyloma 58%, CIN 2 18%, CIN 3/CIS 11%, microinvasion 2% and invasion 1%. The Pap test showed: HGSIL 27%, LGSIL 56%, ASCUS 13%, and normal/benign in 4%. The therapeutic efficiency of the excisional treatment showed that there was a 9.5% excessive treatment, 14.8 residual lesions, 3 cases of hemorrhage, 2 cervical stenosis, and 7 cases with specimen alteration that made the pathological diagnostic difficult or impossible. In conclusion, the LLETZ/conisation are ambulatory procedures with an acceptable rate of over-treatment and residual lesions, and reduced rate of complication.

MeSH terms

  • Adult
  • Algorithms
  • Biopsy, Needle*
  • Colposcopy / methods
  • Conization*
  • Electrosurgery / methods*
  • Female
  • Genotype
  • Gynecologic Surgical Procedures / methods*
  • Humans
  • Hysterectomy / methods
  • Middle Aged
  • Papanicolaou Test
  • Papillomaviridae / genetics
  • Predictive Value of Tests
  • Retrospective Studies
  • Uterine Cervical Dysplasia / pathology*
  • Uterine Cervical Dysplasia / surgery*
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / surgery*
  • Vaginal Smears / methods