Large loop excision and cold coagulation for management of cervical intraepithelial neoplasia

Allam, Mohamed N.; Paterson, Andrew M.; Thomson, A. J.; Ray, B.; Rajagopalan, Chitra; Sarkar, Gita

doi:10.1016/j.ijgo.2004.09.019

Cited by 10 publications

(12 citation statements)

References 31 publications

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“…The similar result was reported in previous studies [1618]. It means that patients with high-grade CIN may have more chance of high-risk HPV infection, and subsequent cellular dysplasia.…”

Section: Discussionsupporting

confidence: 90%

“…In the current study, we applied cold coagulation for controlling bleeding after LEEP like a previous study [16]. The reason is that the incidence of complicated bleeding may be 1% in patients treated with LEEP combined with cold coagulation, whereas it occurs 2% to 2.6% after LEEP alone [31619].…”

Section: Discussionmentioning

confidence: 99%

“…The reason is that the incidence of complicated bleeding may be 1% in patients treated with LEEP combined with cold coagulation, whereas it occurs 2% to 2.6% after LEEP alone [31619]. Thus, it is possible that the application time of the probe heated to 120℃ was not enough to kill cells infected with high-risk HPV, although most of residual dysplastic cells were removed during cold coagulation after LEEP.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, LEEP combined with cold coagulation has been suggested for treating CIN more effectively in previous studies [1516]. In these studies, cold coagulation was expected to eliminate residual dysplastic cells on the resection margin after LEEP if present [17].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of loop electrosurgical excision procedure with cold coagulation for treating cervical intraepithelial neoplasia: A two center cohort study

et al. 2017

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ObjectiveTo evaluate the efficacy of loop electrosurgical excision procedure (LEEP) combined with cold coagulation for treating cervical intraepithelial neoplasia (CIN).MethodsWe reviewed clinic-pathologic data of 498 patients treated with LEEP alone (n=354), and LEEP combined with cold coagulation (n=144) between January 2000 and December 2011. After LEEP, we followed up all patients by using Papanicolaou smear and human papillomavirus (HPV) test, and evaluated abnormal cervical cytology-free interval and high-risk HPV infection-free interval. Moreover, we investigated independent factors affecting abnormal cervical cytology or high-risk HPV infection after LEEP.ResultsAbnormal cervical cytology-free interval was longer in patients treated with LEEP combined with cold coagulation than in those treated with LEEP alone (mean, 92.4 vs. 84.4 months; P=0.01), and patients treated with LEEP combined with cold coagulation also showed longer high-risk HPV infection-free interval than those treated with LEEP alone (mean, 87.6 vs. 59.1 months; P=0.01). Moreover, CIN 3 and cold coagulation were factors affecting abnormal cervical cytology after LEEP (adjusted hazard ratios, 1.90 and 0.61; 95% confidence intervals, 1.27 to 2.84 and 0.39 to 0.96), and CIN 3, positive deep cervical margin and cold coagulation were also factors affecting high-risk HPV infection after LEEP (adjusted hazard ratios, 2.07, 4.11, and 0.64; 95% confidence intervals, 1.38 to 3.08, 1.63 to 10.39, and 0.43 to 0.96). When we performed subgroup analyses for patients with CIN 2 or CIN 3, the result were similar.ConclusionLEEP combined with cold coagulation may be more effective for treating CIN than LEEP alone. Moreover, cold coagulation may decrease the risk of potential of recurrence after LEEP.

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“…The similar result was reported in previous studies [1618]. It means that patients with high-grade CIN may have more chance of high-risk HPV infection, and subsequent cellular dysplasia.…”

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of loop electrosurgical excision procedure with cold coagulation for treating cervical intraepithelial neoplasia: A two center cohort study

et al. 2017

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“…El bajo número de recidivas y/o persistencias confirmadas por citología e histología positiva, resultan similares a nuestras cifras, siendo menos frecuentes en LIE de bajo que las de alto grado (14,17,19), también podrían explicarse por el concepto de erradicación del HPV por el procedimiento electro quirúrgico.…”

Section: Discussionunclassified

Escisión De La Zona De Transformación en Lesiones De Cérvix: Análisis De 1.141 Casos

D¹,

G²,

M³

et al. 2008

Rev. chil. obstet. ginecol.

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RESUMENObjetivo: Analizar los resultados de la escisión de la zona de transformación del cérvix efectuadas en la Unidad de Patología Cervical del Hospital Guillermo Grant de Concepción. Método: Estudio descriptivo, retrospectivo, de los antecedentes clínicos e histológicos de 1.141 casos de escisión electro quirúrgica efectuados entre 1999 a 2005, con seguimiento mínimo de 18 meses. Resultados: De las 3.004 mujeres derivadas por citología positiva para neoplasia y/o HPV, a 1.141 (37,9%) se les realizó escisión de la zona de transformación; 1.113 con asa electroquirúrgica (97,5%) y 28 (2,5%) cono frío con bisturí. Las lesiones intraepiteliales (LIE) de alto grado fueron las más frecuentes (66,7%), seguidas por las LIE de bajo grado (7,8%); el 6,5% de las pacientes presentan etapas iniciales de carcinoma invasor; 33% de las piezas histológicas presentaron bordes comprometidos; 18,4% no presentaron lesión histológica, que sumadas a 7,8% de LIE de bajo grado representan un 26,2% de mujeres consideradas como sobretratadas. El porcentaje a 18 meses de seguimiento en mujeres con LIE de alto grado fue de 85,5%. Necesitaron de una segunda intervención 194 pacientes (17%), 110 (9,6%) por persistencia y recidivas de la lesión. Conclusión: Los resultados presentados son satisfactorios en el porcentaje de curación de las LIE de alto grado como en el aporte al diagnóstico precoz de carcinomas del cérvix y similares a estudios publicados tanto nacionales como extranjeros. /or condyloma, 1,113 (97.5%) were treated with loop electrosurgical excisional procedure (LEEP) and 28 (2.5%) with cold-knife conization. The most frequent lesion (66.7%) found was high grade squamous intraepithelial lesions (SIL), follow by low grade SIL (7.8%); 74 patients (6.5%) presented with early stage of squamous cell carcinoma and 377 (33%) of the histological specimens revealed positive margins; 210 (18.4%) of the cases showed no histological lesion.

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Histopathological challenges in assessing invasion in squamous, glandular neoplasia of the cervix

Al‐Nafussi

2006

Current Diagnostic Pathology

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Large loop excision and cold coagulation for management of cervical intraepithelial neoplasia

Abstract: Large loop excision combined with cold coagulation is a new and effective treatment for CIN. Randomized controlled trials are required to confirm these findings and determine the long-term safety of the technique.

Cited by 10 publications

References 31 publications

Efficacy of loop electrosurgical excision procedure with cold coagulation for treating cervical intraepithelial neoplasia: A two center cohort study

Efficacy of loop electrosurgical excision procedure with cold coagulation for treating cervical intraepithelial neoplasia: A two center cohort study

Escisión De La Zona De Transformación en Lesiones De Cérvix: Análisis De 1.141 Casos

Histopathological challenges in assessing invasion in squamous, glandular neoplasia of the cervix

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