Necessity of colposcopy and biopsy prior to large loop excision of the transformation zone (LLETZ).
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.
Hefler
Lukas
L
Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. lukas.hefler@meduniwien.ac.at
Polterauer
Stephan
S
Nowotny
Gustav
G
Tempfer
Clemens
C
Kohlberger
Petra
P
Sliutz
Gerhard
G
Speiser
Paul
P
Joura
Elmar
E
Reinthaller
Alexander
A
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