title: Use of a portable diathermy machine for LEEP without colposcopy during see-and-treat management of VIA-positive cervical lesions in resource-poor settings.
abstract: OBJECTIVE
  To compare the effectiveness of cryotherapy and loop electrosurgical excision procedure without colposcopy (visual LEEP) in treating cervical lesions detected through visual inspection with acetic acid (VIA).
  
  
  METHODS
  In rural southeast Nigeria, women with VIA-positive lesions who were eligible for ablative treatment were selected to undergo immediate cryotherapy with nitrous oxide. Women with VIA-positive lesions who were not eligible for ablative treatment were selected to undergo visual LEEP at the same visit. A portable diathermy machine was used for LEEP. Participants were re-evaluated 6 months later using VIA. The main outcome measures included persistent VIA positivity at 6 months, duration of procedure, second clinic visits for complications, and patient acceptability.
  
  
  RESULTS
  In total, 304 women completed the study. Persistent VIA-positivity rates, duration of procedure, second clinic visits for complications, and patient acceptability were similar in the 2 groups.
  
  
  CONCLUSIONS
  Visual LEEP and cryotherapy have similar efficacy and patient acceptability in see-and-treat management of VIA-positive cervical lesions. In see-and-treat VIA-based cervical cancer prevention programs in low-resource countries, visual LEEP can be used to treat women who do not meet the criteria for ablative treatment. This would increase the treatment coverage of women with VIA-positive lesions and improve program efficiency.
authors.affiliation: Department of Obstetrics and Gynecology, University of Nigeria Enugu Campus, Enugu, Nigeria. Electronic address: chchigbu@yahoo.com.
authors.forename: Chibuike O
authors.initials: CO
authors.lastname: Chigbu
authors.affiliation: Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria.
authors.forename: Azubuike K
authors.initials: AK
authors.lastname: Onyebuchi
mesh_terms: D019342:Acetic Acid; D000328:Adult; D003452:Cryosurgery / Q000009:adverse effects; D003906:Developing Countries; D055088:Early Detection of Cancer; D004564:Electrocoagulation / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D007202:Indicators and Reagents; D008875:Middle Aged; D009549:Nigeria; D061646:Operative Time; D017060:Patient Satisfaction; D018579:Patient Selection; D010865:Pilot Projects; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000601:surgery*
chemical_list: D007202:Indicators and Reagents; D019342:Acetic Acid
keywords: Cervical cancer prevention; Loop electrosurgical excision procedure; See and treat; Visual inspection with acetic acid