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Persistent minor smear abnormalities: is large loop excision of the transformation zone (LLETZ) the solution?
N Pisal1, M Sindos, M E Mansell
1Department of Women's Health, Whittington Hospital, London, UK. pisal@dr.com
Summary
Large loop excision of the transformation zone (LLETZ) effectively manages persistent borderline or mild cervical abnormalities. This procedure led to normal follow-up smears in 95% of women, indicating successful treatment for minor dyskaryosis.
Area of Science:
- Gynecology
- Cervical Pathology
- Colposcopy
Background:
- Persistent borderline or mild dyskaryosis on cervical smears requires effective management.
- Current guidelines often recommend continued cytological surveillance for these minor abnormalities.
Purpose of the Study:
- To evaluate the efficacy of Large Loop Excision of the Transformation Zone (LLETZ) for managing women with persistent minor cervical abnormalities.
- To assess the rate of negative follow-up smears after LLETZ in this patient group.
Main Methods:
- Prospective observational study involving 102 women with four or more abnormal cervical smears.
- Women opted for LLETZ over continued cytological surveillance.
- Histological analysis of LLETZ specimens and follow-up cervical smear results were recorded.
Main Results:
- Histology revealed CIN2/3 in 11 cases, CGIN in one, CIN1 in 32, and HPV changes in 10.
- 95% (97 out of 102) of women achieved a negative follow-up cervical smear after LLETZ.
Conclusions:
- LLETZ is a highly effective treatment for women with persistent borderline or mild cervical dyskaryosis.
- The procedure demonstrates a high success rate in achieving negative cytology, reducing the need for prolonged surveillance.
