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47 Performance of cone biopsy excision for treatment of cervical intraepithelial neoplasia
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  1. Ahmad Sanad
  1. Minia University, Obstetrics and Gynecolog

Abstract

Introduction/Background Cervical cancer is to a great extent preventable disease through detection and treatment of cervical intraepithelial neoplasia (CIN). All local treatment modalities are efficient in preventing CIN. The influence of different techniques on the risk of recurrence remains therefore unclear. The minimum radicality of treatment to prevent treatment-induced morbidity and the increased risk of future invasion is required. The aim of the study was to assess the adequacy of cone biopsy excision of naked eye lesions as a method of treatment of cervical intraepithelial neoplasia (CIN). Women treated with LEEP were used as control.

Methodology The current study was randomized clinical trial. Cone biopsy excision of naked eye lesions was compared to LEEP of the transformation zone in women undergoing surgical treatment of CIN. The primary outcome was involvement status of the margin of the resected cone. Secondary outcomes were procedure time, blood loss, hemostasis time, intraoperative and postoperative complications, size of the resected area and postoperative pain, validated by visual analog scale (VAS).

Results Ninety women were evaluated for disease persistence after excision of the naked eye lesions using cone biopsy excision. Eighty-five cases treated with excision of the transformation zone using LEEP. There is no statistically significant difference as regarding the margin involvement of the resected cone, the primary outcome, was observed between cone biopsy excision and LEEP (11/90 [12%] vs 8/85 [9.4%], respectively; p = 0.55, OR=1.34 95% CI: 0.5115). Postoperative pain was lower after cone biopsy excision (VAS: 0 [0–2] vs1 [0–3]; p = 0.02). The secondary outcome parameters; procedure time, blood loss, hemostasis time, intraoperative and postoperative complications and size of the resected area were not different between the study groups. Age, parity, contraception method and body mass index did not influence the primary and secondary outcome parameters using multivariate analysis.

Conclusion Cone biopsy excision and LEEP are evenly effective and safe procedures.

Disclosures No conflict of interest related to this research.

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