Outcomes of loop electrosurgical excision procedure for cervical neoplasia in human immunodeficiency virus-infected women

Abstract

The objective of this study was to evaluate the treatment outcomes and complications in human immunodeficiency virus (HIV)-infected women undergoing loop electrosurgical excision procedure (LEEP) for cervical neoplasia. The medical record of 60 evaluable HIV-infected women who had abnormal Papanicolaou (Pap) smear and underwent LEEP following colposcopy at Chiang Mai University Hospital between May 1998 and June 2004 was reviewed. Thirty-one (51.7%) had associated genital infection at screening. Twenty-five (41.7%) had opportunistic infection, but only 18 (30.0%) were treated with antiretroviral therapy. The most common abnormal Pap smear was high-grade squamous intraepithelial lesion (46.7%), followed by low-grade squamous intraepithelial lesion (40.0%). Forty (66.7%) women had clear surgical margins after LEEP. Only one (1.7%) woman had severe intraoperative hemorrhage. Early and late postoperative hemorrhage were noted in three (5%) women of each period. Localized infection of the cervix was detected in seven (11.7%) women. Two (3.3%) women developed cervical stenosis at 6 months after LEEP. There was no significant difference in overall complications between HIV-infected women and the control group (P= 0.24). Among 60 HIV-infected women, no statistical difference in the rate of margins involvement (P= 1.00) and complications (P= 0.85) could be demonstrated between HIV-infected women who received antiretroviral therapy and those who did not. Disease-free rate at 6 and 12 months were 97.1% and 88%, respectively. These data demonstrated that LEEP appears to be safe and effective in HIV-infected women.

Effectiveness and safety of loop electrosurgical excision procedure for cervical neoplasia in rural India

“…Our overall cure rate of 94% compares favorably with the 90%-95% from nonrandomized studies [1][2][3][4][5][6]8]. Adverse effects and complications were observed in a negligible proportion of women and none were major or life threatening, which is similar to those reported in other studies [1][2][3][4][5][6][7][8][17][18][19].…”

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

“…The findings of the present study and those from other low-income country settings [8,20,21] reinforce that LEEP can be performed effectively in these settings with a low frequency of complications and high rates of disease control. The widespread use of LEEP to treat CIN that requires excision should be an important integral component of screening programs in low-income countries.…”

“…In the present study, adverse effects and complications following LEEP were observed in a negligible proportion of women and none were major or life threatening. The frequency of adverse effects and complications favorably compares with those reported from other studies in both high-and low-income countries [1][2][3][4][5][6][7]20,21].…”

Management of cryotherapy-ineligible women in a “screen-and-treat” cervical cancer prevention program targeting HIV-infected women in Zambia: Lessons from the field

“…In a study of 60 HIV-infected women receiving LEEP in Thailand, no significant difference in complications could be demonstrated between HIV-infected women and the control group nor between HIV-infected women receiving antiretroviral therapy and those not receiving antiretroviral therapy [22]. We confirm the safety profile of LEEP in HIV-infected women in a resource-constrained setting with the largest such cohort reported based on our review of the English language medical literature.…”