Effectiveness and safety of loop electrosurgical excision procedure in a low‐resource setting

Rema, P.; Suchetha, S.; Somanathan, Thara; Fayette, Jean Marie; Wesley, Ramani; Sankaranarayanan, Rengaswamy

doi:10.1016/j.ijgo.2008.06.020

Cited by 32 publications

(31 citation statements)

References 18 publications

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“…LEEP has rapidly gained acceptance as a procedure providing specimens for pathological study; it can be performed in an outpatient setting and has an acceptable success rate and low rate of complications [2][3][4][5]. This low-cost procedure is also technically easy to teach and use.…”

Section: Introductionmentioning

confidence: 99%

“Top hat” versus conventional loop electrosurgical excision procedure in women with a type 3 transformation zone

Kietpeerakool

Suprasert

Khunamornpong

et al. 2009

Intl J Gynecology & Obste

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Section: Introductionmentioning

confidence: 99%

“Top hat” versus conventional loop electrosurgical excision procedure in women with a type 3 transformation zone

Kietpeerakool

Suprasert

Khunamornpong

et al. 2009

Intl J Gynecology & Obste

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“…Other methods such as visual inspection after application of Lugol's iodine or with magnifying device (VIAM; ref. 45), as well as loop electrosurgical procedure (46), were likewise shown to be feasible and effective screening methods.…”

Section: Discussionmentioning

confidence: 98%

Ethnicity and Health Care in Cervical Cancer Survival: Comparisons between a Filipino Resident Population, Filipino-Americans, and Caucasians

Redaniel

Laudico

Mirasol-Lumague³

et al. 2009

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Few studies have assessed and compared cervical cancer survival between developed and developing countries, or between ethnic groups within a country. Fewer still have addressed how much of the international or interracial survival differences can be attributed to ethnicity or health care. To determine the role of ethnicity and health care, 5-year survival of patients with cervical cancer was compared between patients in the Philippines and Filipino-Americans, who have the same ethnicity, and between Filipino-Americans and Caucasians, who have the same health care system. Cervical cancer databases from the Manila and Rizal Cancer Registries and Surveillance, Epidemiology, and End Results 13 were used. Age-adjusted 5-year survival estimates were computed and compared between the three patient groups. Using Cox proportional hazards modeling, potential determinants of survival differences were examined. Overall 5-year relative survival was similar in FilipinoAmericans (68.8%) and Caucasians (66.6%), but was lower for Philippine residents (42.9%). Although late stage at diagnosis explained a large proportion of the survival differences between Philippine residents and Filipino-Americans, excess mortality prevailed after adjustment for stage, age, and morphology in multivariate analysis [relative risk (RR), 2.07; 95% confidence interval (CI), 1.68-2.55]. Excess mortality decreased, but persisted, when treatments were included in the multivariate models (RR, 1.78; 95% CI, 1.41-2.23). A moderate, marginally significant excess mortality was found among Caucasians compared with Filipino-Americans (adjusted RR, 1.22; 95% CI, 1.01-1.47). The differences in cervical cancer survival between patients in the Philippines and in the United States highlight the importance of enhanced health care and access to diagnostic and treatment facilities in the

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“…Wright et al has reported cure rate of LEEP to be 94% with large electrode and 80% with small electrode 9 while Rema et al stated the effectiveness of 93% in CIN 1, 85.5% in CIN 2 and 72% in CIN 3. 10 Margin status is used as a predictor for residual or recurrent disease, although several studies have reported that margin status does not adequately predict probability of residual disease. 12 In our study 22 (78.5%) had margin negative; six cases (21.5%) had focal peripheral margin positive which contradicts the study by Kim et al where resected margins were positive in 81.39%.…”

Section: Discussionmentioning

confidence: 99%

Loop Electrosurgical Excision Procedure in Cervical Intraepithelial Neoplasia

Maharjan

Thapa

Chitrakar

et al. 2016

Nepal j. obstet. gynaecol.

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Aims: To evaluate the treatment outcome and acceptance of LEEP in precancerous cervical lesions.Methods: This is a descriptive study performed in Gynecology Department of Civil Service Hospital, from August 2014 - December 2015 in 28 cases that underwent LEEP forCIN. LEEP was performed as day care procedure under intravenous anesthesia and patient was sent home six hours after procedure. Follow up and further treatment was done after final histopathological reports.Results: Highest percentage ofCIN, 32.14% (9) was seen among 30-39 years age with 16 (57.14%) of parity three and more. 17 (60.71%) presented clinic with symptoms (lower abdominal, backpain, pervaginal discharge) while 11 (39.28%) were diagnosed from routine Pap test. Histopathology revealed four (14.28%)CIN1, eight (28.57%)CIN2, 11(39.28%)CIN3, two adenocarcinoma in situ, one of invasive squamous cell carcinoma, chronic cervicitis and atrophic change with no dysplasia. Margins were negative (satisfactory) in 20 (71.42%) and positive in eight (28.57%) with endocervical involvement in two that required second LEEP while one underwent radical hysterectomy for final diagnosis of invasive squamous cell carcinoma.Conclusions: Hysterectomy is a radical procedure for preinvasive cervical lesions that can be treated with simple procedure like LEEP that saves time and financial resources.

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Effectiveness and safety of loop electrosurgical excision procedure in a low‐resource setting

Abstract: LEEP was associated with minimal complications and acceptable cure rates in a low-resource setting, although women with larger lesions had lower cure rates.

Cited by 32 publications

References 18 publications

“Top hat” versus conventional loop electrosurgical excision procedure in women with a type 3 transformation zone

“Top hat” versus conventional loop electrosurgical excision procedure in women with a type 3 transformation zone

Ethnicity and Health Care in Cervical Cancer Survival: Comparisons between a Filipino Resident Population, Filipino-Americans, and Caucasians

Loop Electrosurgical Excision Procedure in Cervical Intraepithelial Neoplasia

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