Pure cutting current for loop excision of squamous intraepithelial lesions

Area of Science:

• Gynecologic Oncology
• Surgical Pathology
• Colposcopy

Background:

• Complete excision of cervical premalignant lesions requires clear margins for accurate pathological evaluation.
• Previous large loop excision techniques utilized blended currents, potentially causing thermal damage due to higher voltage.
• Thermal damage can compromise specimen integrity and surgical outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of using pure cutting current for large loop excision of the transformation zone (LLETZ) in cervical premalignant lesions.
• To assess the depth of thermal damage associated with pure cutting current LLETZ.
• To determine the rate of intraoperative and delayed bleeding complications.

Main Methods:

• A series of 20 patients underwent LLETZ using pure cutting current for cervical premalignant lesions.
• Thermal damage depth was histopathologically assessed in 6 patients.
• Preoperative injection of a vasoconstrictor was employed for hemostasis.

Main Results:

• The average depth of thermal damage was 0.47 mm in the endocervical zone and 0.43 mm in the exocervical zone.
• No intraoperative or delayed bleeding complications were observed in any of the procedures.
• The surgical technique allowed for clear visualization of the cervical base and glands.

Conclusions:

• Pure cutting current LLETZ is a safe and effective method for excising cervical premalignant lesions with minimal thermal damage.
• This technique facilitates complete lesion removal with clear margins and reduces the risk of bleeding.
• The use of a vasoconstrictor aids in achieving hemostasis during the procedure.