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Comparative analysis of transcervical resection and loop electrosurgical excision in the treatment of high‐grade cervical intraepithelial neoplasia
Author(s) -
Chen Meizhuang,
Cai Huihua,
Chen Songqiang,
Wu Xinyi,
Ma Xiao,
Liu Mubiao,
Chen Le
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12655
Subject(s) - medicine , loop electrosurgical excision procedure , cervical intraepithelial neoplasia , adverse effect , retrospective cohort study , surgery , resection , cervical cancer , cancer
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.