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Deep loop excision for prehysterectomy endocervical evaluation
B B Bennett1, I K Stone, C D Anderson
1Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, USA.
Objective:
Our purpose was to determine whether office deep loop excision should replace cone biopsy for frozen-section endocervical evaluation before planned hysterectomy.
Study Design:
This cohort study comprised 31 patients who underwent office deep loop excision with frozen-section analysis followed by hysterectomy and 50 historic controls who underwent cone biopsy with frozen-section analysis followed by hysterectomy. Diagnostic accuracy, margin status, presence of residual disease, morbidity, and cost were compared.
Results:
Loop excision frozen sections had sensitivity (ectocervical specimen, 96%; deepest endocervical specimen, 93%), specificity (100%, 86%), and positive (100%, 88%) and negative (75%, 92%) predictive values similar to those of frozen cone biopsy (95%, 80%, 98%, and 67%, respectively. No differences in margin status, presence of residual dysplasia, or morbidity were observed. The shorter operating room time for vaginal hysterectomy after loop excision (p < 0.01) resulted in an approximate $2000 savings.
Conclusion:
Office loop excision is a cost-effective option for endocervical evaluation before planned hysterectomy.