Randomized clinical trial comparing cold knife conization of the cervix with and without lateral hemostatic sutures

Bueno, Letícia Rossi; Binda, Marcia; Monego, Heleusa Ione; Scherer, Roberta Luísa; Rolim, Karen Machado; Bottini, Alessandra Leal; Fregnani, José Humberto Tavares Guerreiro; Reis, Ricardo dos

doi:10.1016/j.ijsu.2015.04.081

Cited by 6 publications

(6 citation statements)

References 6 publications

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“…Consistent with our results, another study by Letícia Rossi Bueno et al (22) investigated the cold-knife conization with and without sutures and found similar results. The authors found no difference in bleeding between the two groups of with and without sutures.…”

Section: Discussionsupporting

confidence: 92%

“…Many studies have explored different methods and techniques for reducing cold-knife conization complications. The reduction of operation duration for patients treated with non-suture techniques has also been reported in some studies (18)(19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 55%

“…In the mid-20th century, the hemostatic sutures were added to the cold-knife conization technique to minimize blood loss (17). Since then, using these sutures and their effectiveness has been discussed by many authors (18)(19)(20)(21)(22). This study compares the effect of these sutures on patients undergoing cold-knife conization.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the hemostatic suture with non-suture cold-knife conization methods for cervical surgery

Gürbüz¹,

Yardımcı

2020

Journal of Health Sciences and Medicine

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 55%

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Comparison of the hemostatic suture with non-suture cold-knife conization methods for cervical surgery

Gürbüz¹,

Yardımcı

2020

Journal of Health Sciences and Medicine

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“…CKC requires general anesthesia, and bleeding is an important complication ( 20 ) . Despite many variations in the surgical technique ( 21 ) , we used the lateral hemostatic sutures at 3 and 9 o’clock positions, and the mentor described the proper borders with regard to the bladder and rectum to totally excise the dysplastic area.…”

Section: Discussionmentioning

confidence: 99%

The impact of Loop Electrosurgical Excision Procedure and cold-knife conization training model on the surgical skills and confidence level

Selçuk¹,

Ersak²,

Umaroğlu³

et al. 2020

tjod

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Objective: The purpose of this study is to evaluate the impact of loop electrosurgical excision procedure (LEEP) and cold-knife conization (CKC) active training model on the surgical education and confidence levels of gynecologists. Materials and Methods: The LEEP and CKC hands-on training model consists of sausage, which is 2.5 cm in diameter, as cervix; plastic cup as vagina; foam rubber as posterior and anterior fornices; and cotton plate as the leukoplakia area. In total, 34 participants performed LEEP and CKC procedures on the training model under the guidance of mentors after theoretical lessons about the transformation zone, indications, and surgical techniques of LEEP and CKC. Afterward, a web-based survey was conducted to measure the effectiveness of this surgical model, and participants graded their learning and confidence levels on the same. Results: We evaluated the educational levels of the course, which were based on the basic surgical steps of LEEP and CKC procedures, and the confidence levels of the participants with regard to the previous practice or expertise of LEEP and CKC. Importantly, participants in each group had similar learning gains irrespective of previous practice or expertise. Despite a significantly higher pre-course confidence level of participants who had previously performed LEEP (p<0.001) and CKC (p<0.001) against their non-practitioner counterparts, the post-course confidence levels were similar in each group (p=0.127 and p=0.845, respectively). In both groups, the participants had increased mean confidence scores, which were statistically significant for participants who had not previously performed the procedures (p=0.003, LEEP and p=0.002, CKC, respectively). Conclusion: This surgical training model on LEEP and CKC can impart a better level of education in participants, irrespective of their previous expertise/practice.

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“…Cervical intraepithelial neoplasia (CIN) is a common precancerous lesion in women of reproductive age group worldwide [1]. Although no treatment is considered superior among the various excisional treatment modalities [1][2][3][4], the loop electrosurgical excision procedure (LEEP) has widely been preferred. This is because it can be performed under local anesthesia, it is easy to obtain specimens for pathological examination, and it has a high success rate with low major surgical morbidity rates [1,5].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a kaolin-impregnated gauze in the prevention of postoperative bleeding after cervical conization

Song¹,

Kim²,

Lee³

2021

European Journal of Gynaecological Oncology

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To evaluate the efficacy of a kaolin-impregnated gauze in preventing postoperative bleeding after a loop electrosurgical excision procedure (LEEP). Methods: The medical records of 1322 women who underwent a LEEP at a university hospital were retrospectively reviewed, of which 1006 patients who fulfilled the inclusion criteria were included in the final analysis. During the study period, the bleeding in patients undergoing a LEEP was managed with the application of a kaolin-impregnated gauze (treatment group, n = 539) or without application of a kaolin-impregnated gauze (control group, n = 467). The primary outcome measure was the incidence of postoperative bleeding requiring hemostatic intervention after a LEEP. A logistic regression model was used to identify the clinical variables for postoperative bleeding. Results: The baseline characteristics were similar between the two study groups. Postoperative vaginal bleeding necessitating an intervention was observed in 12.8% of the study population (129 of 1006 women), with a significant difference between the two groups (9.3% in the treatment group vs. 16.9% in the control group; p < 0.001). On multivariate analysis, significantly lower postoperative bleeding was observed with the use of a kaolinimpregnated gauze than without its use (odds ratio = 0.496; 95% confidence interval = 0.267-0.870; p = 0.009). Conclusions: Prophylactic use of a kaolin-impregnated gauze reduced the incidence of postoperative bleeding after a LEEP.

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Randomized clinical trial comparing cold knife conization of the cervix with and without lateral hemostatic sutures

Cited by 6 publications

References 6 publications

Comparison of the hemostatic suture with non-suture cold-knife conization methods for cervical surgery

Comparison of the hemostatic suture with non-suture cold-knife conization methods for cervical surgery

The impact of Loop Electrosurgical Excision Procedure and cold-knife conization training model on the surgical skills and confidence level

Efficacy of a kaolin-impregnated gauze in the prevention of postoperative bleeding after cervical conization

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