Large loop excision of the transformation zone for treating cervical intraepithelial neoplasia: a 12-year experience.
BACKGROUND
Although the existing evidence suggests that there is no obviously superior conservative method for treating cervical intraepithelial neoplasia (CIN), one of the most widely used is the large loop excision of the transformation zone (LLETZ).


METHODS
A total of 897 women who were treated with LLETZ at our colposcopy clinic from 1989 to 2000 were retrospectively studied.


RESULTS
Forty women did not have significant cervical pathology (4.5% over-treatment rate). Clear margins of excision were obtained in 748 (88.5%) of the 845 cases of CIN or microinvasive cancers. Treatment failure rates were 4.7% for clear margins and 26.8% for involved or uncertain.


CONCLUSIONS
LLETZ is a fast and reliable method of treating CIN and microinvasive carcinoma. Generalized cauterization of the resulting crater should be avoided and satellite HPV lesions ablated. Involved margins have a higher treatmentfailure rate, therefore a larger excision is recommended as cervical craters regenerate. Treatment in pregnant women can be delayed until postpartum provided they have adequate surveillance during pregnancy.
Paraskevaidis
E
E
Academic Unit of Obstetrics and Gynaecology, St Mary's Hospital, Manchester, UK. vangelispar@hotmail.com
Koliopoulos
G
G
Malamou-Mitsi
V
V
Zikopoulos
K
K
Paschopoulos
M
M
Pappa
L
L
Agnantis
N J
NJ
Loli
D E
DE
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D003127:Colposcopy; D019092:Conization; D004564:Electrocoagulation; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D009361:Neoplasm Invasiveness; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*