Diathermy large loop excision of thansformation zone [LLETZ] as a treatment of cervical intraepithelial neoplasia [CIN]: the use of a cheap, locally made, replacable loop

ABSTRACT

In selectcd cases with CIN, outpatient excisional procedures represent a readily accepted and highly effective modality of treatment The aim of this work is to evaluate the efficacy of a cheap, locally made, replacable stainless steel loop electrode used with an ordinary diathermy generator and local anaesthesia using a dental syringe, in LLETZ procedure. 18 patients with histologically proved CIN were selected for this study. The mean duration of the procedure was 3.94 +/- 0.72 minutes [range 3 to 5 minutes]. The procedure was well tolerated by the patients, only 2 [11.2%] experienced mild discomfort. Haemorrhagic morbidity was not a problem. one patient [5.6%] had mild operative bleeding and 2 [11.2%] had mild postoperative bleeding after 2 hours that was easily controlled. All the LLETZ specimens were adequate for histopathological diagnosis and there was a good correlation between pretreatment and LLETZ specimens, with undercall diagnosis in only one case [5.6%]. After 3 months 17 patients and 6 months 15 patients, returned for follow up. Cytological follow up was completely normal after 3 months. but showed one case of HPV after 6 months. Colposcopy was normal after 3 months with 2 unsatisfactory Colposcopy but it showed one case with acetowhite epithelium [flat condyloma on pathology] and one unsatisfactory colposcopy after 6 months. Our patient diathermy LLETZ with cheap, replacable loops and dental syringe local anaesthesia, are cost effective, and well tolerated alternative to other modalities for treatment of CIN