International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2018
Comparative analysis of transcervical resection and loop electrosurgical excision in the treatment of high-grade cervical intraepithelial neoplasia.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Chen Meizhuang, Cai Huihua, Chen Songqiang, Wu Xinyi, Ma Xiao, Liu Mubiao, Chen Le
Аннотация
OBJECTIVE: To compare the efficacy of transcervical resection of the cervix (TCRC) and loop electrosurgical excision procedure (LEEP) in the treatment of high-grade cervical squamous intraepithelial lesions (HSIL).
METHODS: A retrospective case record review was conducted of patients with HSIL treated with TCRC or LEEP at Guangdong General Hospital, Guangdong Academy of Medical Sciences and Zhujiang Hospital, Guangzhou, China, from 2009 to 2015. The clinical characteristics, cone margin statuses, clinical outcomes, and adverse events were compared between the two groups.
RESULTS: Among 647 included patients, 292 (45.1%) were treated with TCRC and 355 (54.9%) with LEEP. The incidences of positive margins, persistent and recurrent lesions, and intraoperative bleeding were lower in the TCRC group than in the LEEP group (P<0.001 for all comparisons). The rates of cervical adhesions were comparable between the two groups. During TCRC, 78 (26.7%) intrauterine lesions were diagnosed; most of these had been missed by transvaginal sonography.
CONCLUSION: TCRC may be an alternative method to LEEP in the treatment of HSIL. Compared with LEEP, TCRC has comparable clinical efficacy without additional adverse events. Moreover, TCRC is useful for detecting and/or removing intrauterine lesions during surgery.
METHODS: A retrospective case record review was conducted of patients with HSIL treated with TCRC or LEEP at Guangdong General Hospital, Guangdong Academy of Medical Sciences and Zhujiang Hospital, Guangzhou, China, from 2009 to 2015. The clinical characteristics, cone margin statuses, clinical outcomes, and adverse events were compared between the two groups.
RESULTS: Among 647 included patients, 292 (45.1%) were treated with TCRC and 355 (54.9%) with LEEP. The incidences of positive margins, persistent and recurrent lesions, and intraoperative bleeding were lower in the TCRC group than in the LEEP group (P<0.001 for all comparisons). The rates of cervical adhesions were comparable between the two groups. During TCRC, 78 (26.7%) intrauterine lesions were diagnosed; most of these had been missed by transvaginal sonography.
CONCLUSION: TCRC may be an alternative method to LEEP in the treatment of HSIL. Compared with LEEP, TCRC has comparable clinical efficacy without additional adverse events. Moreover, TCRC is useful for detecting and/or removing intrauterine lesions during surgery.