Literature DB >> 24431670

LLETZ Specimen Fragmentation: Impact on Diagnosis, Outcome, and Implications for Training.

Rasiah Bharathan1, Balvinder Sagoo1, Aravind Subramaniam1, Peter Larsen-Disney1, Andrew Fish1.   

Abstract

PURPOSE: This study was designed to assess fragmentation of Large loop excision of the transformation zone (LLETZ) specimens, its influence on short-term cytological outcome, and the risk factors for specimen fragmentation, as we well as trainee performance on clinical outcome.
METHOD: This retrospective study was performed at a cancer center. Women who underwent LLETZ for suspected high-grade cervical intra-epithelial neoplasia (CIN) over a 5-year period were included. Patients were identified through a regional database. Data were obtained from hospital and regional databases. Fisher's exact test was used.
RESULTS: 75 % of all specimens were obtained intact. When the LLETZ specimen was intact, 89 % of smear tests were reported as negative, against 86 % when the specimen was fragmented. Fragmentation was significantly associated with high-grade smear results at 6 months. Trainee status was significantly related to specimen fragmentation.
CONCLUSION: Fragmentation of LLETZ specimens is associated with an increased likelihood of obtaining a high-grade smear at 6 months post treatment. Enhancing the colposcopy training may help improve clinical outcome.

Entities:  

Keywords:  Colposcopy training; Cytological outcome; LLETZ; Specimen fragmentation

Year:  2013        PMID: 24431670      PMCID: PMC3798435          DOI: 10.1007/s13224-012-0332-8

Source DB:  PubMed          Journal:  J Obstet Gynaecol India        ISSN: 0975-6434


  17 in total

1.  What do master surgeons think of surgical competence and revalidation?

Authors:  A Cuschieri; N Francis; J Crosby; G B Hanna
Journal:  Am J Surg       Date:  2001-08       Impact factor: 2.565

2.  Is needle diathermy excision of the transformation zone a better treatment for cervical intraepithelial neoplasia than large loop excision?

Authors:  P S Basu; T D'Arcy; A McIndoe; W P Soutter
Journal:  Lancet       Date:  1999-05-29       Impact factor: 79.321

3.  Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training.

Authors:  Anthony G Gallagher; E Matt Ritter; Howard Champion; Gerald Higgins; Marvin P Fried; Gerald Moses; C Daniel Smith; Richard M Satava
Journal:  Ann Surg       Date:  2005-02       Impact factor: 12.969

4.  Large-loop excision of the transformation zone: effect on the pathologic interpretation of resection margins.

Authors:  F J Montz; C H Holschneider; L D Thompson
Journal:  Obstet Gynecol       Date:  1993-06       Impact factor: 7.661

5.  Colposcopy and cervical biopsy educational training models.

Authors:  D G Ferris; A G Waxman; M D Miller
Journal:  Fam Med       Date:  1994-01       Impact factor: 1.756

Review 6.  The human face of simulation: patient-focused simulation training.

Authors:  Roger Kneebone; Debra Nestel; Cordula Wetzel; Steven Black; Ros Jacklin; Raj Aggarwal; Faranak Yadollahi; John Wolfe; Charles Vincent; Ara Darzi
Journal:  Acad Med       Date:  2006-10       Impact factor: 6.893

7.  Psychomotor testing predicts rate of skill acquisition for proficiency-based laparoscopic skills training.

Authors:  Dimitrios Stefanidis; James R Korndorffer; F William Black; J Bruce Dunne; Rafael Sierra; Cheri L Touchard; David A Rice; Ronald J Markert; Peter R Kastl; Daniel J Scott
Journal:  Surgery       Date:  2006-08       Impact factor: 3.982

Review 8.  Surgery for cervical intraepithelial neoplasia.

Authors:  Pierre Pl Martin-Hirsch; Evangelos Paraskevaidis; Andrew Bryant; Heather O Dickinson; Sarah L Keep
Journal:  Cochrane Database Syst Rev       Date:  2010-06-16

9.  LLETZ is an acceptable alternative to diagnostic cold-knife conization.

Authors:  R W Naumann; M C Bell; R D Alvarez; R P Edwards; E E Partridge; C W Helm; H M Shingleton; J A McGee; R V Higgins; J B Hall
Journal:  Gynecol Oncol       Date:  1994-11       Impact factor: 5.482

10.  Efficacy and safety of large-loop excision of the transformation zone.

Authors:  A Bigrigg; D K Haffenden; A L Sheehan; B W Codling; M D Read
Journal:  Lancet       Date:  1994-01-01       Impact factor: 79.321

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  2 in total

1.  The Role of Surgeons' Colposcopic Experience in Obtaining Adequate Samples by Large Loop Excision of the Transformation Zone in Women of Reproductive Age.

Authors:  R Sparić; A Tinelli; M Guido; R Stefanović; I Babović; V Kesić
Journal:  Geburtshilfe Frauenheilkd       Date:  2016-09-05       Impact factor: 2.915

2.  TWENTY-YEAR EXPERIENCE WITH LARGE LOOP EXCISION OF THE TRANSFORMATION ZONE AT SESTRE MILOSRDNICE UNIVERSITY HOSPITAL CENTRE.

Authors:  Dražan Butorac; Bernarda Škrtić; Marijo Čukelj; Krunoslav Kuna; Ivka Djaković
Journal:  Acta Clin Croat       Date:  2019-09       Impact factor: 0.780

  2 in total

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