title: Necessity of colposcopy and biopsy prior to large loop excision of the transformation zone (LLETZ).
abstract: BACKGROUND
  The clinical value of colposcopy and biopsy prior to large loop excision of the cervical transformation zone (LLETZ) with respect to negative histology and positive specimen margin rates, was evaluated.
  
  
  METHODS
  A total of 2,050 consecutive patients who had undergone LLETZ from 1997 to 2005, were included. As diagnostic workup prior to LLETZ, 290 patients underwent repeat PAP test only and 1,760 patients had undergone colposcopy/biopsy.
  
  
  RESULTS
  The diagnostic approach using colposcopy/biopsy reduced the rates of negative histology and positive margins from 6.0% to 1.9% (p < 0.001) and from 28.2% to 21.7% (p = 0.002), respectively. The rates of invasive carcinomas were not different between the groups (6.6% vs. 6.5%; p = 0.9).
  
  
  CONCLUSIONS
  Performing colposcopy and biopsy prior to LLETZ reduces unnecessary surgical procedures and decreases positive margin rates.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. lukas.hefler@meduniwien.ac.at
authors.forename: Lukas
authors.initials: L
authors.lastname: Hefler
authors.forename: Stephan
authors.initials: S
authors.lastname: Polterauer
authors.forename: Gustav
authors.initials: G
authors.lastname: Nowotny
authors.forename: Clemens
authors.initials: C
authors.lastname: Tempfer
authors.forename: Petra
authors.initials: P
authors.lastname: Kohlberger
authors.forename: Gerhard
authors.initials: G
authors.lastname: Sliutz
authors.forename: Paul
authors.initials: P
authors.lastname: Speiser
authors.forename: Elmar
authors.initials: E
authors.lastname: Joura
authors.forename: Alexander
authors.initials: A
authors.lastname: Reinthaller
mesh_terms: D000328:Adult; D001706:Biopsy / Q000379:methods; D003127:Colposcopy / Q000379:methods; D005260:Female; D006801:Humans; D012189:Retrospective Studies; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D014626:Vaginal Smears