Premium
Value‐based medicine analysis on loop electrosurgical excision procedure and CO 2 laser vaporization for the treatment of cervical intraepithelial neoplasia 2
Author(s) -
Sun Lulu,
Cao Dongyan,
Yang Jiaxin,
Bian Meilu,
Wei Lihui,
Shen Keng
Publication year - 2012
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2011.01832.x
Subject(s) - medicine , cervical intraepithelial neoplasia , laser vaporization , loop electrosurgical excision procedure , colposcopy , electrosurgery , significant difference , laser surgery , surgery , cytology , quality of life (healthcare) , gynecology , cervical cancer , laser , pathology , cancer , optics , physics , nursing
Aim: The best treatment option for cervical intraepithelial neoplasia 2 (CIN2) is controversial and there is a lack of studies in value‐based medicine. This multicenter comparative study was undertaken to evaluate the effectiveness, cost‐effectives and quality of life (QOL) of loop electrosurgical excision procedure (LEEP) and CO 2 laser vaporization for the treatment of CIN2. Material and Methods: A database of LEEP and laser vaporizations performed at three research centers was created. Patients with colposcopic‐histopathologically confirmed CIN2 were randomly submitted to LEEP and laser vaporization. Cytology, human papilloma virus (HPV) DNA test and histology were performed, and a questionnaire on QOL was filled out during follow‐up. Effectiveness, cost‐effectives and QOL were analyzed. Results: Three hundred and thirty‐eight women with CIN2 were included in the study. Frequencies of remission, and persistent and recurrent CIN were 89.2%, 7.2%, and 3.6% for LEEP, and 86.7%, 12.6%, 0.70% for laser, respectively. There was no significant difference in remission and persistence of CIN. There was a significant difference in the number of operations, recovery time and costs. Women treated with two methods showed relatively identical QOL. Conclusion: Both LEEP and CO 2 laser vaporization are effective and reliable treatments for CIN2, whereas cervical tissue can be obtained for histology by LEEP. Preoperative evaluation and postoperative follow‐up are important. Gynecologists should pay attention to QOL of patients with CIN.