Diathermy loop excision in the management of cervical intraepithelial neoplasia: diagnosis and treatment in one procedure.
OBJECTIVE
Diathermy loop excision was performed as a new diagnostic-treatment in patients with cervical cytologic diagnoses consistent with an epithelial abnormality.


METHODS
A total of 424 patients with cervical cytologic diagnoses consistent with an epithelial abnormality, but macroscopically or colposcopically not consistent with invasive carcinoma, were subjected to diathermy loop excision to diagnose and treat cervical lesions in one procedure.


RESULTS
The diagnostic accuracy rate was 99%. In patients with histologically confirmed grade 3 cervical intraepithelial neoplasia, pretreatment cytologic diagnosis and subsequent histopathologic diagnosis corresponded in 73% of cases. In 91% of all patients the diathermy loop excision was sufficient for complete treatment. Cervical morphologic findings after treatment allowed adequate cytologic follow-up. There was no evidence that diathermy loop excision influenced fertility or pregnancy outcome.


CONCLUSIONS
Diathermy loop excision is a reliable, well-tolerated, inexpensive, and efficient technique for the management of cervical intraepithelial neoplasia. This outpatient procedure is especially recommended in younger patients, because diathermy loop excision preserves the function of the cervix.
Keijser
K G
KG
Department of Obstetrics and Gynecology, University Hospital Nijmegen, The Netherlands.
Kenemans
P
P
van der Zanden
P H
PH
Schijf
C P
CP
Vooijs
G P
GP
Rolland
R
R
D004564:Electrocoagulation / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D009017:Morbidity; D011183:Postoperative Complications; D011247:Pregnancy; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery