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. Copyright 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
RCT Entities:
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. Copyright 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Authors: G F Vercellino; V Chiantera; J Gaßmann; E Erdemoglu; I Drechsler; S Frangini; A Schneider; G Böhmer Journal: Geburtshilfe Frauenheilkd Date: 2012-10-23 Impact factor: 2.915