Grana L, Meikle S, Orleans M; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1995; 11: Abstract No. 29.
University of Colorado Health Sciences Center, Denver, USA.
OBJECTIVE: Screening for cancer of the cervix by cervial cytology, the pap smear, and colposcopic biopsy has been shown to reduce the rate of cervical cancer. Cervical cancer screening programs use two procedures to rule out invasive disease and to treat high grade dysplastic cervial lesions. One of the procedures, cone biopsy, is performed in the operating room and involves removal of the squamocolumnar junction where ninety-five percent of cervical cancers occur. The second is a new technology called large loop excision of the transformation zone (LLETZ) which is an office-based procedure and differs from cone biopsy in that cautery is used to obtain the specimen under local anesthesia. Lletz may differ from cone biopsy in several ways, including the amount of heat artifact in the pathology specimen, cost, complications, and the amount of tissue removed. Indications for use of the procedure may also differ. Many young women of reproductive age, including teenagers, have been treated with this newer and widely adapted technique. However, there has not been a comparison of lletz to cone biopsy, the gold standard treatment of severe cervical dysplasia, for differences in later experiences of these young patients. METHODS: An historical prospective chart review was performed for all patients who had undergone treatment for moderate and severe cervical dysplasia at Denver General Hospital since July 1991 when the lletz procedure was introduced. Four hundred ninety-three women were identified including two hundred twenty-seven women with CIN II and two hundred sixty-six women with CIN III by colposcopically directed biopsies. In order to compare the outcomes of the lletz procedure with those of cone biopsy, indications for treatment, demographics, margin status, recurrent and residual disease, complications, and pregnancy outcomes (in those women who became pregnant after the procedure) were examined in this population. RESULTS: Current analyses reveal savings in both time and actual costs (LLETZ $538.00 vs. cone $3169.50 at Denver General Hospital) and no increase in patient morbidity in regard to complications of bleeding and infection using the less costly procedure. Further analyses will focus on indications and pregnancy outcomes for the two procedures.
Publication Types:
Keywords:
- Adolescent
- Biopsy
- Cervical Intraepithelial Neoplasia
- Cervix Uteri
- Colposcopy
- Conization
- Electrosurgery
- Female
- Gynecologic Surgical Procedures
- Humans
- Hydrotherapy
- Hysteroscopy
- Laser Therapy
- Longitudinal Studies
- Pregnancy
- Recurrence
- Uterine Cervical Neoplasms
- Vaginal Smears
- cytology
- methods
- surgery
- therapy
- utilization
- hsrmtgs
Other ID:
UI: 102215783
From Meeting Abstracts