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A comparative study of efficacy and outcomes of large loop excision of the transformation zone procedure performed under general anaesthesia versus local anaesthesia
Author(s) -
Borbolla Foster Ailsa,
Symonds Ian
Publication year - 2012
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2012.01420.x
Subject(s) - medicine , general anaesthesia , regional anaesthesia , anesthesia , cervical intraepithelial neoplasia , dysplasia , surgery , cervical cancer , cancer
Background Although A ustralian N ational H ealth and M edical R esearch C ouncil ( NHMRC ) guidelines do not specify targets for mode of anaesthesia for large loop excision of the transformation zone ( LLETZ ) procedures, UK NHS C ervical S creening P rogramme ( NHSCSP ) guidelines recommend that >80% of LLETZ procedures be performed under local anaesthesia. There is a paucity of clinical data regarding both the proportion of women receiving general anaesthesia for treatment, factors underpinning this choice and the impact of mode of anaesthesia on treatment outcomes. Aims To identify the proportion of women who have a LLETZ under general anaesthesia and to establish the impact of mode of anaesthesia on outcomes including treatment efficacy, overtreatment (negative histology), short‐term morbidity and attendance for follow‐up. Methods Single‐centre retrospective analysis of all women treated with LLETZ for suspected cervical dysplasia between 1, M ay 2005 and 1, M ay 2009. Results Thirty‐three percent of a total 465 LLETZ procedures were carried out under general anaesthesia, although the reason for anaesthesia choice was not recorded in 52% of cases. There were no significant differences in the primary outcomes of unclear LLETZ margins or negative LLETZ histology, or in the secondary outcomes of depth and surface area of LLETZ specimen, short‐term morbidity or rates of incomplete follow‐up. Conclusions Although reasons underpinning selection of anaesthesia mode remain elusive, at this centre, outcomes following LLETZ procedure for the management of suspected cervical dysplasia are not affected by the mode of anaesthesia used.