title: The Role of Surgeons' Colposcopic Experience in Obtaining Adequate Samples by Large Loop Excision of the Transformation Zone in Women of Reproductive Age.
abstract: Introduction:There is insufficient reporting on the level of colposcopic training for the safe use of large loop excision of the transformation zone. The aim of this study was to perform a quality assessment of large loop excision of the transformation zone in women of reproductive age by evaluating the surgeons' colposcopic experience.Materials and Methods:A retrospective cohort study was performed on diagnostic or therapeutic large loop excision of the transformation zone. The following variables were analyzed: age, parity, indications for surgery, level of surgeon's colposcopic experience, definitive histological diagnosis, margin involvement, and the presence and type of artifacts interfering with the pathological interpretation. Patients were divided into three groups: group A - 75 patients treated by junior colposcopists; group B - 74 patients treated by experienced colposcopists, and group C - 117 patients treated by expert colposcopists.Results:Regarding the presence and diagnostic significance of the artifacts the groups were significantly different. Inadequate samples were the least frequent in group C. Artifacts precluding histological diagnosis were the most common in group A. The margins were predominantly inconclusive in group A.Conclusions:A high rate of artifacts is a disadvantage of the large loop excision of the transformation zone performed by surgeons less skilled for colposcopy. Although large loop excision of the transformation zone is considered to be a minor surgery, skills in colposcopy are an essential prerequisite for optimal results.
authors.affiliation: Clinic for Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: R
authors.initials: R
authors.lastname: Sparić
authors.affiliation: International Translational Medicine and Biomodeling Research Group Department of Applied Mathematics, Moscow Institute of Physics and Technology (State University), Moscow, Russia; Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy of Centre for Interdisciplinary Research Applied to Medicine Department of Obstetrics and Gynecology Vito Fazzi Hospital, Lecce, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Tinelli
authors.affiliation: Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Guido
authors.affiliation: Department for Histopathology, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: R
authors.initials: R
authors.lastname: Stefanović
authors.affiliation: Clinic for Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: I
authors.initials: I
authors.lastname: Babović
authors.affiliation: Clinic for Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: V
authors.initials: V
authors.lastname: Kesić
keywords: LLETZ; artifacts; colposcopic experience; conization; specimen