Introduction/Background To investigate the factors related to incomplete excision procedure in abnormal cervical cytology among the different levels of surgical education.
Methodology From the medical records, data were collected from patients with abnormal cervical cytology and/or positive HPV test who have underwent colposcopic biopsy and required to be treated by loop electrosurgical excision procedure (LEEP) or cold knife conization (CKC) by obstetrics and gynecology residents or gynecologic oncology fellows under the supervision of senior attending surgeons from 2009 to 2019 in a university affiliated training and research hospital. Age, menopausal status, parity, body mass index, HPV infection, history of smoking, cervical cytology and characteristics of cone histopathology such as number of specimen, size and glandular involvement were investigated for adequacy of specimen interpretability by the pathologist for margin positivity according to educational level of surgeons.
Results Total of 1845 cervical excisional procedures, 67% of them LEEP and 33% of them CKC were performed by residents (43%) or fellows (57%) during this period were analyzed. Margin negative complete excision of the LEEP and CKC specimens were found 81% and 86% in fellows and 67% and 80% in residents, respectively (p=0.003 and 0.02, respectively).
Conclusion Multiple pieces of specimen was the risk factor for incomplete excision of LEEP. Procedures such as cone biopsy should be done only by medical practitioners who have special training, skills, and sufficient experience.
Disclosure Nothing to disclose.
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