One-step management of cervical lesions

Area of Science:

• Gynecology
• Oncology
• Colposcopy

Background:

• Cervical cancer screening often identifies precancerous lesions requiring treatment.
• Current protocols may involve multiple visits for diagnosis and treatment.
• Optimizing the diagnostic and treatment pathway is crucial for patient management and resource allocation.

Purpose of the Study:

• To evaluate the efficacy and practicality of same-visit diagnosis and treatment of cervical lesions using large loop excision of the transformation zone (LLETZ).
• To compare LLETZ with traditional punch biopsy followed by subsequent treatment.

Main Methods:

• 119 patients with abnormal colposcopy findings were divided into two groups.
• Group A (53 patients): received multiple cervical punch biopsies.
• Group B (66 patients): underwent same-visit LLETZ under local anesthesia.

Main Results:

• LLETZ diagnosed various cervical lesions including cervical intraepithelial neoplasia, condyloma acuminatum, granulomatous cervicitis, adenocarcinoma, and squamous cell carcinoma.
• LLETZ specimens had minimal artifact, with 4.5% requiring further treatment.
• Patient satisfaction was significantly higher in the LLETZ group (89%) compared to the biopsy group (38%).
• Further treatment was needed in 55% of the biopsy group versus 4.5% in the LLETZ group.

Conclusions:

• LLETZ is a practical and efficient method for treating cervical lesions during the initial colposcopic visit.
• This approach minimizes complications and avoids a second treatment session, offering significant advantages, especially in resource-limited settings.
• LLETZ can effectively manage many cervical lesions, saving time and resources.