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1.
Obstetrics & Gynecology Science ; : 87-91, 2017.
Artículo en Inglés | WPRIM | ID: wpr-34441

RESUMEN

OBJECTIVE: The aim of this study was to investigate factors preventing delayed hemorrhage after the loop electrosurgical excisional procedure (LEEP). METHODS: Medical records of patients who underwent LEEP at one university affiliated hospital from October 2013 to January 2015 were reviewed. Patients with or without delayed hemorrhage were classified. LEEP was performed either in an operating room under general anesthesia or in a procedure room with local anesthesia in the outpatient clinic. Delayed hemorrhage was defined as excisional site bleeding occurring between 1 and 30 days after the LEEP requiring intervention such as electro-cauterization, gauze packing, or application of another hemostatic agent. RESULTS: During the study period, 369 patients underwent LEEP. Twenty-three (6.2%) patients with delayed hemorrhage returned to our hospital either to the outpatient clinic or to the emergency unit. A third of the population (103, 27.9%) underwent LEEP in the operating room under general anesthesia without injection of local anesthesia. The remaining patients (266, 72.1%) underwent LEEP with local anesthesia (lidocaine HCl 2% with epinephrine 1:100,000) in the office procedure room. Patients given local anesthesia including epinephrine had significantly lower delayed hemorrhage compared to patients with general anesthesia without injection of local anesthesia (P=0.001). Hemostats, such as fibrin glue or patch, were used for the majority of patients (346, 93.8%) during the procedure. However, using hemostats was not statistically associated with delayed hemorrhage (P=0.163). CONCLUSION: Local anesthesia with the powerful vasoconstrictor epinephrine is effective not only to control perioperative bleeding, but also to prevent delayed hemorrhage after LEEP.


Asunto(s)
Humanos , Instituciones de Atención Ambulatoria , Anestesia General , Anestesia Local , Servicio de Urgencia en Hospital , Epinefrina , Adhesivo de Tejido de Fibrina , Hemorragia , Registros Médicos , Quirófanos
2.
Obstetrics & Gynecology Science ; : 200-206, 2017.
Artículo en Inglés | WPRIM | ID: wpr-194736

RESUMEN

OBJECTIVE: To evaluate the efficacy of loop electrosurgical excision procedure (LEEP) combined with cold coagulation for treating cervical intraepithelial neoplasia (CIN). METHODS: We reviewed clinic-pathologic data of 498 patients treated with LEEP alone (n=354), and LEEP combined with cold coagulation (n=144) between January 2000 and December 2011. After LEEP, we followed up all patients by using Papanicolaou smear and human papillomavirus (HPV) test, and evaluated abnormal cervical cytology-free interval and high-risk HPV infection-free interval. Moreover, we investigated independent factors affecting abnormal cervical cytology or high-risk HPV infection after LEEP. RESULTS: Abnormal cervical cytology-free interval was longer in patients treated with LEEP combined with cold coagulation than in those treated with LEEP alone (mean, 92.4 vs. 84.4 months; P=0.01), and patients treated with LEEP combined with cold coagulation also showed longer high-risk HPV infection-free interval than those treated with LEEP alone (mean, 87.6 vs. 59.1 months; P=0.01). Moreover, CIN 3 and cold coagulation were factors affecting abnormal cervical cytology after LEEP (adjusted hazard ratios, 1.90 and 0.61; 95% confidence intervals, 1.27 to 2.84 and 0.39 to 0.96), and CIN 3, positive deep cervical margin and cold coagulation were also factors affecting high-risk HPV infection after LEEP (adjusted hazard ratios, 2.07, 4.11, and 0.64; 95% confidence intervals, 1.38 to 3.08, 1.63 to 10.39, and 0.43 to 0.96). When we performed subgroup analyses for patients with CIN 2 or CIN 3, the result were similar. CONCLUSION: LEEP combined with cold coagulation may be more effective for treating CIN than LEEP alone. Moreover, cold coagulation may decrease the risk of potential of recurrence after LEEP.


Asunto(s)
Humanos , Displasia del Cuello del Útero , Estudios de Cohortes , Prueba de Papanicolaou , Recurrencia
3.
China Pharmacist ; (12): 101-102, 2015.
Artículo en Chino | WPRIM | ID: wpr-462502

RESUMEN

Objective:To discuss the curative effect of lacidophilin vaginal capsules combined with loop electrosurgical excisional procedure ( LEEP) in the treatment of cervical erosion with chronic cervicitis. Methods:Totally 72 cases of patients with cervical ero-sion with chronic cervicitis were selected and divided into the observation group and the control group at random. The patients in the two groups were given routine LEEP with the application of antibiotics to prevent infection for 1 week. The patients in the observation group were additionally given lacidophilin vaginal capsules, placed in the vagina after the operation, one capsule per time at every night for 14 days. The vaginal fluid time and vaginal bleeding time in the two groups were observed. The clinical curative effect and adverse drug reactions ( ADRs) after 8 weeks of the operation were studied and evaluated again. Results: The vaginal bleeding amount and bleeding time in the observation group after the operation was less or shorter than that in the control group (P<0. 05). According to the further consultation after 8 weeks of the operation, the total clinical efficiency in the observation group was 94. 44%, which was ob-viously higher than that in the control group(75. 00%,P<0. 05). There was no obvious ADR appeared in the two groups during the treatment. Conclusion:Lacidophilin vaginal capsules combined with LEEP has reliable curative effect on cervical erosion with chronic cervicitis, which can obviously shorten the wound healing time and decrease the vaginal bleeding amount and time with high security.

4.
Journal of Korean Medical Science ; : 110-113, 2009.
Artículo en Inglés | WPRIM | ID: wpr-112916

RESUMEN

The aim of this study was to compare the rate of incomplete resection and treatment outcome of the second-pass technique with those of single-pass technique in loop electrosurgical excisional procedure (LEEP). From 1997 to 2002, 683 women were diagnosed as squamous dysplasia via LEEP in our institution. Age, parity, LEEP technique, grade of lesion, glandular extension, margin status, residual tumor and recurrence were obtained by reviewing medical records. Positive margin was defined as mild dysplasia or higher grade lesions at resection margin of the LEEP specimen. In women who underwent hysterectomy, residual tumor was defined as mild dysplasia or higher grade lesions in hysterectomy specimen. In women who did not underwent hysterectomy, Pap smear more than atypical squamous cells of undetermined significance or biopsy result more than mild dysplasia within two years after LEEP were regarded as cytologic or histologic recurrences, respectively. Treatment failure of LEEP was defined as residual tumor or histologic recurrence. The second-pass technique significantly reduced the endocervical margin positivity (odds ratio [OR], 0.36; 95% confidence interval [CI], 0.21-0.63). However, the second-pass technique did not reduce the treatment failure (OR, 0.62; 95% CI, 0.29-1.32). In conclusion, the second-pass technique markedly reduced the endocervical margin positivity, but did not reduce the treatment failure rate of LEEP.


Asunto(s)
Adulto , Femenino , Humanos , Persona de Mediana Edad , Displasia del Cuello del Útero/patología , Electrocirugia/métodos , Histerectomía , Registros Médicos , Recurrencia Local de Neoplasia/diagnóstico , Neoplasia Residual/diagnóstico , Oportunidad Relativa , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Neoplasias del Cuello Uterino/patología
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