Deep loop excision for prehysterectomy endocervical evaluation.
OBJECTIVE
Our purpose was to determine whether office deep loop excision should replace cone biopsy for frozen-section endocervical evaluation before planned hysterectomy.


METHODS
This cohort study comprised 31 patients who underwent office deep loop excision with frozen-section analysis followed by hysterectomy and 50 historic controls who underwent cone biopsy with frozen-section analysis followed by hysterectomy. Diagnostic accuracy, margin status, presence of residual disease, morbidity, and cost were compared.


RESULTS
Loop excision frozen sections had sensitivity (ectocervical specimen, 96%; deepest endocervical specimen, 93%), specificity (100%, 86%), and positive (100%, 88%) and negative (75%, 92%) predictive values similar to those of frozen cone biopsy (95%, 80%, 98%, and 67%, respectively. No differences in margin status, presence of residual dysplasia, or morbidity were observed. The shorter operating room time for vaginal hysterectomy after loop excision (p < 0.01) resulted in an approximate $2000 savings.


CONCLUSIONS
Office loop excision is a cost-effective option for endocervical evaluation before planned hysterectomy.
Bennett
B B
BB
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, USA.
Stone
I K
IK
Anderson
C D
CD
Wilkinson
E J
EJ
D000328:Adult; D001706:Biopsy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D011300:Preoperative Care