Sunida Panna1, Sanguanchoke Luanratanakorn. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, Srinangarind Hospital, Khon Kaen University, Khon Kaen, Thailand.
Abstract
OBJECTIVES: To determine the prevalence and predictive factors of residual disease in the specimens from cold knife conization (CKC) or the loop electrosurgical excision procedure (LEEP) and complication rates of these procedures. DESIGN: Descriptive analytical study in Srinangarind Hospital, Khon Kaen, Thailand, of a total of 463 patients with abnormal Pap smears who underwent LEEP or CKC during 2002-2007. METHODS: The medical records of 463 women were retrospectively reviewed to ascertain the prevalence, associated factors of positive surgical margin, and complications of LEEP and CKC. The patients' characteristics and pathologic parameters were collected and analyzed. Univariate analysis was based with the chi-square test and the Student's t-test. Multiple logistic regression models were employed to investigate factors associated with cone margin involvement. RESULTS: Of the 463 patients, 124 cases had a positive cone margin (26.8%). 53 patients had complications (11.4%), such as bleeding (25) and infection (28). The margin involvement was significantly associated with type of conization, purpose of conization, skill of surgeon, and histological diagnosis. CONCLUSION: The prevalence of a positive cone margin is rather high. Physicians who perform conization should take into account risk factors in management of cases with abnormal cytological screening for cervical cancer.
OBJECTIVES: To determine the prevalence and predictive factors of residual disease in the specimens from cold knife conization (CKC) or the loop electrosurgical excision procedure (LEEP) and complication rates of these procedures. DESIGN: Descriptive analytical study in Srinangarind Hospital, Khon Kaen, Thailand, of a total of 463 patients with abnormal Pap smears who underwent LEEP or CKC during 2002-2007. METHODS: The medical records of 463 women were retrospectively reviewed to ascertain the prevalence, associated factors of positive surgical margin, and complications of LEEP and CKC. The patients' characteristics and pathologic parameters were collected and analyzed. Univariate analysis was based with the chi-square test and the Student's t-test. Multiple logistic regression models were employed to investigate factors associated with cone margin involvement. RESULTS: Of the 463 patients, 124 cases had a positive cone margin (26.8%). 53 patients had complications (11.4%), such as bleeding (25) and infection (28). The margin involvement was significantly associated with type of conization, purpose of conization, skill of surgeon, and histological diagnosis. CONCLUSION: The prevalence of a positive cone margin is rather high. Physicians who perform conization should take into account risk factors in management of cases with abnormal cytological screening for cervical cancer.
Authors: Bruno O Fonseca; Júlio C Possati-Resende; Mila P Salcedo; Kathleen M Schmeler; Guilherme S Accorsi; José H T G Fregnani; Marcio Antoniazzi; Naitielle P Pantano; Iara V V Santana; Graziela M Matsushita; Ricardo Dos Reis Journal: Obstet Gynecol Date: 2021-06-01 Impact factor: 7.661