engleski

Sixteen years of Large loop excision of the transformation zone (LETZ) in University hospital center “Sisters of Charity” Zagreb, Croatia

OBJECTIVE: The purpose of this study was to determine whether the loop electrosurgical excision procedure (LEEP) is as effective as cold knife conisation (CKC) in the removal of cervical dysplasia. Purpose and methods of study : This retrospective study had been performed from 1995 to 2012 and included 1748 surgically treated females with a cervical dysplasia. 1018 (58%) subjects were treated by large loop excision of the transformation zone (LLETZ) while at 730 (42%) females classical conization with cold knife was done. Results: Results of the pathohistological diagnosis were as follows: in 174 (10%) patients dysplasia was not confirmed ; CIN1 in 190 (11%) ; CIN2 in 351 (20%) ; CIN3 in 814 (46%) ; CIS in 169 (10%) ; Carcinoma planocellulare in 35 (2%) ; AIS in 13 (1%) and adenocarcinoma in 2 (0.1%) of all patients. From all patohistological results without dysplasia , 57% (99/174) were in the LLETZ group, and from all CIN1 cases , 70% (133/190) were in LLETZ group. CIN2+ patohistological results was represented in 776 cases (44%) in the LLETZ subgroup and in 558 cases (66%) in the subgroup of patients treated with the conisation with cold knife. Residual dysplasia was found on the borders of the cone in 113 (6.4%) patients there of 47% were in LLETZ treated subgroup. Excochleat of residual cervical canal was positive in 151 (8.6%) of females. Conclusions: Treatments of premalignant cervix lesions by LLETZ and by cold knife conization have shown equal outcomes. Differences in indications, according to current protocols, could explain divergence in outcomes as well as higher frequency of CIN2+ in LLETZ treated subgroup. It has to be pointed, there is, also, a diagnostic conization which determines the stage of the disease regarding further treatment. In our study, results from both categories are in accordance with the previously published data.

large loop excision of the transformation zone

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