Treatment of Cervical Intraepithelial Neoplasia in a Prospective Study Comparing Large-Loop Excision of the Transformation Zone, Laser Vaporization, and Knife Cone Biopsy

Gonzalez-Bosquet, Jesus; Centeno, Cristina; Bermejo, Begoña; Jou, P.; Puig-Tintoré, Luis-Maria; Xercavins, Jordi; González-Merlo, J

doi:10.1097/00128360-199710000-00006

Cited by 7 publications

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“…Seven studies, including two randomized controlled trials (RCTs) 6 , 7 and five non-RCTs, 17 – 21 reported recurrence rates, and the results of the individual studies varied. A meta-analysis based on all these seven studies revealed that patients in CKC group had slightly lower recurrence rate than those in LLETZ/LEEP group (RR =1.75, 95% CI =0.99–3.11, P =0.06; Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia

Jiang¹,

Chang-xian²,

Li³

2016

OTT

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ObjectiveThis meta-analysis aimed to compare the superiority of loop electrosurgical excision procedure (LEEP) or large loop excision of the transformation zone (LLETZ) versus cold-knife conization (CKC) in the surgical treatment of cervical intraepithelial neoplasia (CIN).MethodsSystematic searches were performed in the MEDLINE, EMBASE, Cochrane databases, and the China National Knowledge Infrastructure Databases to identify all potential articles involving patients with CIN treated with LEEP/LLETZ or CKC published up to February 2016. Risk ratios (RRs) or weighted mean difference (MD) with a 95% confidence interval (95% CI) were calculated.ResultsSeven randomized controlled trials, one prospective cohort study, and twelve retrospective cohort studies were included in this meta-analysis. There were no significant differences following LEEP/LLETZ compared with CKC in recurrence rate (RR =1.75, 95% CI =0.99–3.11, P=0.06), positive margin rate (RR =1.45; 95% CI =0.85–2.49, P=0.17), residual disease rate (RR =1.15, 95% CI =0.73–1.81, P=0.48), secondary hemorrhage (RR =1.16, 95% CI =0.74–1.81; P=0.46), or cervical stenosis. Moreover, subgroup analyses based on randomized trials also revealed that no statistical significance was observed in the above outcomes. However, women treated with CKC had a significantly deeper cervical cone than those treated with LLETZ/LEEP (MD =−5.71, 95% CI =−7.45 to −3.96; P<0.001).ConclusionLEEP/LLETZ is as effective as CKC with regard to recurrence rate, positive margin rate, residual disease rate, secondary hemorrhage, and cervical stenosis for the surgical treatment of CIN. Further large-scale studies are needed to confirm our findings.

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Section: Resultsmentioning

confidence: 99%

Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia

Jiang¹,

Chang-xian²,

Li³

2016

OTT

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“…The LLETZ has been used in Europe and the United States as a primary treatment option for CIN (1–4) . It has become the most widely used treatment for CIN in the UK.…”

Section: Discussionmentioning

confidence: 99%

Chronic pelvic pain: a rare complication following a large-loop excision of the transformation zone

Sieunarine

Lawton

Smith

2006

Int J Gynecol Cancer

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This is the unique report of a patient with deep-seated, left-sided pelvic pain following a large-loop excision of the transformation zone (LLETZ) for cervical intraepithelial neoplasia III. She transpired to have a definite diagnosis of pelvic varicosities which were only on the left side. Our surmise was that the varicosities had risen on the back of an arteriovenous malformation following her LLETZ performed by a colleague. The first attempted treatment was radiologic embolization. When this failed, she had a formal surgical procedure, and the left unilateral varicosities were ligated. Her pain ceased entirely thereafter, and she remained pain free at her 1-year review.

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“…The LLETZ has been used in Europe and the United States as a primary treatment option for CIN (1)(2)(3)(4) . It has become the most widely used treatment for CIN in the UK.…”

Section: Discussionmentioning

confidence: 99%

Chronic pelvic pain: a rare complication following a large-loop excision of the transformation zone

Sieunarine,

Lawton,

Smith

2006

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

Treatment of Cervical Intraepithelial Neoplasia in a Prospective Study Comparing Large-Loop Excision of the Transformation Zone, Laser Vaporization, and Knife Cone Biopsy

Cited by 7 publications

References 0 publications

Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia

Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia

Chronic pelvic pain: a rare complication following a large-loop excision of the transformation zone

Chronic pelvic pain: a rare complication following a large-loop excision of the transformation zone

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