Benefits of Direct Colposcopic Vision for Optimal LLETZ Procedure

Préaubert, Lise; Gondry, J.; Mancini, Julien; Chevreau, Julien; Lamblin, G.; Atallah, Anthony; Lavoué, Vincent; Caradec, Claire; Baldauf, Jean-Jacques; Bryand, Angélique; Henno, Sébastien; Villeret, Julia; Agostini, Aubert; Douvier, S.; Jarniat, Adélaide; Riethmuller, Didier; Mendel, Anne; Brun, Jean‐Luc; Rakotomahenina, H; Carcopino, Xavier

doi:10.1097/lgt.0000000000000156

Cited by 12 publications

(10 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies, the use of DCV was shown to help in minimizing the dimensions of the excised specimen, including the thickness, without compromising the margins status. 18,26,27 In addition to the potential subsequent obstetrical benefit, the systematic use of DCV should therefore also be recommended to reduce the risk of compromised post-LLETZ follow-up as a result of the reduction of the thickness of the excised tissue. However, independently to the thickness of the excised specimen, our study shows the use of DCV to significantly and massively reduce the risk of inadequate colposcopic examination.…”

Section: Discussionmentioning

confidence: 99%

“…This study is a secondary follow-up analysis of the ICORAD prospective multicenter observational study, performed in nine teaching hospitals in France, that aimed to investigate the benefit of the use of direct colposcopic vision for the guidance of LLETZ. 18 ICORAD is the French acronym of "Impact de la Colposcopie sur la Résection à l'Anse Diathermique," which translates to "Impact of Colposcopy on LLETZ." From December 2013 to July 2014, a total of 249 all patients who had a LLETZ performed for the treatment of colposcopically and histologically proven HSIL were recruited to participate in this study.…”

Section: Methodsmentioning

confidence: 99%

“…Precise description of the characteristics of the surgeons was made in the initial ICORAD study publication. 18 The use of colposcopy made during each LLETZ procedure was systematically documented. Three groups were considered: LLETZ achieved without any colposcopic examination at the time of the procedure and solely guided by the previous colposcopic report, LLETZ achieved under naked eyes vision immediately after a colposcopic examination had been performed, and LLETZ fully achieved under direct colposcopic vision (DCV).…”

Section: Large Loop Excision Of the Transformation Zone Proceduresmentioning

confidence: 99%

“…Finally, one should also consider that no sample size calculation was made because this study is a secondary follow-up analysis of a prospective project. 18…”

Section: Strength and Limitationsmentioning

confidence: 99%

See 3 more Smart Citations

Risk Factors of Inadequate Colposcopy After Large Loop Excision of the Transformation Zone: A Prospective Cohort Study

Carcopino

Mancini

Gondry

et al. 2018

J Low Genit Tract Dis

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Large Loop Excision Of the Transformation Zone Proceduresmentioning

confidence: 99%

“…Finally, one should also consider that no sample size calculation was made because this study is a secondary follow-up analysis of a prospective project. 18…”

Section: Strength and Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Risk Factors of Inadequate Colposcopy After Large Loop Excision of the Transformation Zone: A Prospective Cohort Study

Carcopino

Mancini

Gondry

et al. 2018

J Low Genit Tract Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…Two groups of treatment methods are used: destructive and excisional [10][11][12][13][14][15][16][17].…”

Section: Methods For Treatment Of Cervical Precancerous Lesionsmentioning

confidence: 99%

Treatment of cervical intraepithelial neoplasia in outpatient practice

Kornovski¹,

Ivanova²,

Kostov³

et al. 2021

fmpcr

View full text Add to dashboard Cite

Background. the treatment of cin is based on two criteria: colposcopic assessment of the altered area and histological verification -the presence and degree of dysplasia are histological diagnoses. Objectives. To present some destructive (cryodestruction, CO 2 laser vaporisation, radiofrequency ablation) and excisional (LLETZ/ /SWETZ) treatment techniques for cervical intraepithelial neoplasia (CIN), their selection criteria and application in outpatient practice. Material and methods. This is a retrospective study over a period of one year, which included 101 patients with histologically verified CIN. The diagnosis was made after targeted biopsy under colposcopic control or through a see-and-treat strategy. The following methods were applied: video colposcopy, co 2 laser vaporisation using video colposcopy, cryodestruction, LLETZ (SWETZ) under video colposcopic control. Results. Destruction treatment was administered to 46 patients (45.5%). Excision therapy was performed on 55 patients (54.5%). CO 2 laser vaporisation was performed on 20 (43.5%) of the patients with destructive treatment, cryodestruction -on 20 (43.5%), and radiofrequency ablation -on 6 (13%) patients. All patients on excision therapy underwent the LLETZ procedure. After a median follow-up of 2.5 years, no high grade squamous intraepithelial lesion (HGSIL) recurrence was observed. Conclusions. The characteristics of the altered area, the squamous-cylindrical epithelium border and degree of CIN's are decisive for the choice of treatment method -destruction or excision. The role of colposcopy, in this respect, is essential. CINs are successfully treated in an outpatient setting by destructive (CO 2 laser vaporisation, cryodestruction) and excisional methods (LLETZ, SWETZ).

show abstract

Video colposcopy versus headlight for large loop excision of the transformation zone (LLETZ): a randomised trial

Rezniczek

Neghabian

Rehman

et al. 2021

Arch Gynecol Obstet

View full text Add to dashboard Cite

Purpose To compare resected cone mass and resection margin status when performing Large Loop Excision of the Transformation Zone (LLETZ) using video colposcopy (LLETZ-VC) versus a headlight (LLETZ-HL) in women with cervical dysplasia. Methods Prospective, randomised trial (monocentric) at a specialised cervical dysplasia unit in a University Hospital. Women with a biopsy-proven CIN2 + or persisting CIN1 or diagnostic LLETZ were recruited and randomised. LLETZ was performed either under video colposcopic vision or using a standard surgical headlight. The primary endpoint was resected cone mass. Secondary endpoints were the rate of involved margins, fragmentation of the specimen, procedure time, time to complete haemostasis (TCH), blood loss, pain, intra- and postoperative complications, and surgeon preference. Results LLETZ-VC and LLETZ-HL (109 women each) had comparable cone masses (1.57 [0.98–2.37] vs. 1.67 [1.15–2.46] grams; P = 0.454). TCH was significantly shorter in the LLETZ-VC arm (60 [41–95.2] vs. 90 [47.2–130.2] seconds; P = 0.008). There was no statistically significant difference in involved resection margins (6/87 [6.5%] vs. 16/101 [13.7%], P = 0.068) and postoperative complications (13/82 [13.7%] vs. 22/72 [23.4%], P = 0.085). Patient-reported outcomes favoured LLETZ-VC with a lower use of analgesics (6/80 [7.0%] vs. 17/87 [16.3%]; P = 0.049). However, LLETZ-VC was more difficult to perform with significantly lower ratings for handling (7 [5–9] vs. 9 [8–10]; P < 0.001) and general satisfaction (7.5 [5–9] vs. 10 [8–10]; P < 0.001). Conclusion Intraoperative video colposcopy for LLETZ has minimal benefits at the cost of surgeons’ satisfaction. Clinical trial registration NCT04326049 (ClinicalTrials.gov).

show abstract

Benefits of Direct Colposcopic Vision for Optimal LLETZ Procedure

Abstract: Direct colposcopic vision is associated with a significant decrease in the volume and in all dimensions of LLETZ specimens with no compromise in the margin status.

Cited by 12 publications

References 24 publications

Risk Factors of Inadequate Colposcopy After Large Loop Excision of the Transformation Zone: A Prospective Cohort Study

Risk Factors of Inadequate Colposcopy After Large Loop Excision of the Transformation Zone: A Prospective Cohort Study

Treatment of cervical intraepithelial neoplasia in outpatient practice

Video colposcopy versus headlight for large loop excision of the transformation zone (LLETZ): a randomised trial

Contact Info

Product

Resources

About