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

• Published in: Chirurgia (Bucharest, Romania : 1990) Vol. 104; no. 3; pp. 295 - 301
• Main Authors: Socolov, D, Anton, G, Anton, A C, Anton, E, Socolov, R V, Teleman, S, Melinte, A, Boiculese, L, Stoian, M
• Format: Journal Article
• Language: English
• Published: Romania 01-05-2009
• Subjects: Adult; Algorithms; Biopsy, Needle; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - surgery; 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 Neoplasms - pathology; Uterine Cervical Neoplasms - surgery; Vaginal Smears - methods
• ISSN: 1221-9118

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