"Top hat" versus conventional loop electrosurgical excision procedure in women with a type 3 transformation zone.
OBJECTIVE
To compare the "top-hat" and conventional loop electrosurgical excision procedures (LEEP) performed in women with a type 3 transformation zone to assess the rate of endocervical margin involvement.


METHODS
Women with a type 3 transformation zone randomly allocated into the conventional (n=94) and top-hat LEEP (n=86) groups were analyzed.


RESULTS
The rate of endocervical margin involvement in the top-hat group was lower than that in the conventional group (32.6% vs 53.2%; RR 0.36; 95% CI, 0.19-0.68; P=0.003). Among women with positive endocervical margins, women undergoing top-hat LEEP were less likely to have residual lesions compared with those in the conventional group (52.2% vs 84.1%, respectively, P=0.04). There was no significant difference in the complication rate between the top-hat and conventional groups (7.0% vs 10.6%, respectively, P=0.39).


CONCLUSIONS
Top-hat LEEP performed in women with a type 3 transformation zone reduces the risks of endocervical margin involvement and residual diseases compared with conventional LEEP, with no significant difference in perioperative complications.
Kietpeerakool
Chumnan
C
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. kiet_ji@hotmail.com
Suprasert
Prapaporn
P
Khunamornpong
Surapan
S
Sukpan
Kornkanok
K
Settakorn
Jongkolnee
J
Srisomboon
Jatupol
J
D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery*; D004598:Electrosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology