Author(s):
MD Patrícia Alves, MD Daniela Vila Real, MD Inês Alencoão, MD Maria João Carinhas, MD Cláudia Marques, MD Manuela Montalvão, MD Isabel Rodrigues, MD Madalena Moreira, MD José Cabral
Abstract:
Objective: To compare three methods of excision of the transformation zone (ETZ). Design: A retrospective cross-sectional study, comparing three techniques of ETZ: LASER CO
2, large loop excision of the transformation zone (LLETZ), and needle excision of the transformation zone (NETZ) in a cervical pathology unit between January 2016 and July 2017.
Material and methods: Data files were consulted and complemented with the institutional medical record SClinico
®. The characteristics of the women and the specimen cone were obtained. The complications of the procedures and follow-up at 6 and 12 months were assessed. Statistical analyses were achieved using SPSS
® 25 software.
Results: During the target period, 201 of women were subjected to LASER CO
2, 85 to LLETZ, and 15 to NETZ. The excisional specimens obtained did not show statistical differences in resection margin status and thermal artifacts. On average, only LASER ETZ obtained deeper excisional specimens compared to the other two techniques. During the procedures, NETZ showed a more significant bleeding risk compared to LASER ETZ (RR 0.29, 95%CI 0.09-0.93) and LLETZ (RR 0.17, 95%CI 0.05-0.65). NETZ also presented a 20% higher incidence of postoperative complications. Although the difference was not statistically significant, the women who underwent NETZ showed greater risk of maintaining cytological abnormalities and/or high risk-HPV at the 6
th- and 12
th-month follow-ups.
Conclusion: There is no clear evidence of the best ETZ technique, but it seems that the LASER and LLETZ methods are both safe and effective options in ETZ.
