Large loop excision of the transformation zone (LLETZ) compared to carbon dioxide laser in the treatment of CIN: a superior mode of treatment

Abstract

Summary. A series of 199 patients with histologically confirmed cervical intraepithelial neoplasia (CIN) grade II or III were allocated by hospital number to receive out‐patient treatment by carbon dioxide laser vaporization or large loop excision of the transformation zone (LLETZ). All patients received local anaesthesia. The women in the LLETZ group experienced less post operative haemorrhage, less discomfort, operative time was greatly reduced, and histological material was available for confirmation of the diagnosis. There was no significant difference in recurrence of CIN after treatment between the two groups. At 6 month follow‐up, recurrence rates of 8.2% (CIN II) and 7.5% (CIN III) were observed in the laser‐group and 5% (CIN II) and 5.3% (CIN III) in the LLETZ group. Further advantages of LLETZ are reduced capital expenditure and no hazard to the eyesight of the surgeon, but laser treatment is preferable in patients with widespread vaginal involvement.

Human Papillomavirus Infection After Treatment for High-Grade Cervical Intraepithelial Neoplasia

“…Only 11 cases were considered treatment failures. Failure rates between 5% and 15% have been reported by other authors (1,2,5,11,16,29). The rate of treatment failure in our study is higher (18.6%).…”

A Pilot Study to Investigate the Efficacy of Fibrin Sealant (Tisseel®) in the Loop Electrosurgical Excision Procedure

“…Delayed hemorrhage may occur 1-2 weeks after surgery, which is related to dissolving sutures or erosion of a blood vessel during the healing process. The incidence of postoperative bleeding following LEEP is 0-8% [3,4,5,6,17,18]. However, most studies have focused on the incidence of serious bleeding requiring treatment such as suture or hospitalization.…”

“…Generally, LEEP is a safe procedure, but complications such as abdominal pain, abnormal vaginal discharge, postoperative bleeding and infection have been reported [3,4,5,6]. According to a recent report, the incidence of any of these symptoms after the procedure occurs in up to 52% of cases [7].…”

“…Because ablative therapy does not produce a specimen for additional histologic evaluation, excisional therapy is preferred. The loop electrosurgical excision procedure (LEEP) has many advantages over other types of conization therapy that use cold knife or laser techniques [3,4,5]. It is an inexpensive, technically easy procedure, and healing can be achieved with minimal distortion and low complication rates as well as with good specimen quality [6].…”

Stellenwert des Nachweises von humanem Papillomvirus in der Früherkennung des Zervixkarzinoms

“…Nach Konisation wegen höhergradiger CIN werden Rezidivraten um 5% (0,35-15%) beobachtet [42,43,[45][46][47][48][49] …”