title: A multicentric randomized study comparing two techniques of magnification assisted loop excision of high-grade cervical intraepithelial neoplasia: video exoscopy and colposcopy.
abstract: OBJECTIVE
  To compare loop excisions of cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) under video exoscopy, or colposcopic guidance, with respect to safety and effectiveness.
  
  
  METHODS
  Prospective multicentric randomized trial of 300 patients, undergoing loop excision for CIN 2+ either under video exoscopy (group A) or colposcope (group B) guidance. Intra- and post-operative complications, resection margins, and removed cervical volume in both groups were evaluated.
  
  
  RESULTS
  19.3 % of patients in video exoscopy group and 15.5 % in colposcopy group (p = 0.67) had transformation zone (TZ) 3. 45/151 (29.8 %) of group A patients and 48/149 (32.2 %) of group B patients underwent top-hat procedure, i.e., one superficial excision followed by one deeper removal of the endocervical tissue (p = 0.74). There was no difference in intra- and post-operative complications in the two groups. Positive endocervical resection margins (R0) were 9.9 % in video exoscopy group and 8.7 % in colposcopy group, respectively. Unclear endocervical resection margins (Rx) were 2.0 % in both groups. Mean total excised cervical volume was 1.20 cubic centimeter (cc³) in group A, and 1.24 cc³ in group B, respectively. Recurrent disease occurred in 2.3 % of patients at 6 months follow-up.
  
  
  CONCLUSIONS
  Magnification assisted loop excision of CIN 2+ is equally effective and safe under colposcopic and video exoscopy guidance. The latter technique could potentially offer an alternative treatment of CIN 2+ lesions for doctors unfamiliar with colposcope.
authors.affiliation: Department of Gynecology, Campus Benjamin Franklin, Charité, Hindenburgdamm 30, 12200, Berlin, Germany, enonloso1@hotmail.com.
authors.forename: Giuseppe F
authors.initials: GF
authors.lastname: Vercellino
authors.forename: Evrim
authors.initials: E
authors.lastname: Erdemoglu
authors.forename: Vito
authors.initials: V
authors.lastname: Chiantera
authors.forename: Al-Hakeem
authors.initials: AH
authors.lastname: Malak
authors.forename: Katharina
authors.initials: K
authors.lastname: Vasiljeva
authors.forename: Inka
authors.initials: I
authors.lastname: Drechsler
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Dückelmann
authors.forename: Janine
authors.initials: J
authors.lastname: Richter
authors.forename: Achim
authors.initials: A
authors.lastname: Schneider
authors.forename: Gerd
authors.initials: G
authors.lastname: Böhmer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri / Q000601:surgery; D003127:Colposcopy; D004598:Electrosurgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011247:Pregnancy; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D020535:Video-Assisted Surgery; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*