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“Top hat” versus conventional loop electrosurgical excision procedure in women with a type 3 transformation zone
Author(s) -
Kietpeerakool Chumnan,
Suprasert Prapaporn,
Khunamornpong Surapan,
Sukpan Kornkanok,
Settakorn Jongkolnee,
Srisomboon Jatupol
Publication year - 2010
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 - 10.1016/j.ijgo.2009.11.005
Subject(s) - medicine , loop electrosurgical excision procedure , significant difference , perioperative , surgery , gynecology , cervical intraepithelial neoplasia , cervical cancer , cancer
Objective To compare the “top‐hat” and conventional loop electrosurgical excision procedures (LEEP) performed in women with a type 3 transformation zone to assess the rate of endocervical margin involvement. Methods Women with a type 3 transformation zone randomly allocated into the conventional (n = 94) and top‐hat LEEP (n = 86) groups were analyzed. Results The rate of endocervical margin involvement in the top‐hat group was lower than that in the conventional group (32.6% vs 53.2%; RR 0.36; 95% CI, 0.19–0.68; P = 0.003). Among women with positive endocervical margins, women undergoing top‐hat LEEP were less likely to have residual lesions compared with those in the conventional group (52.2% vs 84.1%, respectively, P = 0.04). There was no significant difference in the complication rate between the top‐hat and conventional groups (7.0% vs 10.6%, respectively, P = 0.39). Conclusion Top‐hat LEEP performed in women with a type 3 transformation zone reduces the risks of endocervical margin involvement and residual diseases compared with conventional LEEP, with no significant difference in perioperative complications.