Excisions of severe cervical dysplasia: Are there mandatory diameters of the cone that need to be considered?
Journal Title: UNKNOWN - Year 2017, Vol 18, Issue 4
Abstract
Objective To achieve optimal depth for negative margin cones after loop electrosurgical excision procedures (LEEP) for cervical dysplasia. Materials and Methods Retrospective cohort analysis of LEEP cones of 201 patients with cervical dysplasia during a four-year period. Analysed cones were divided into two different groups: cones with negative margins without dysplasia, and cones with margins positive for dysplasia. In order to determine the cut-off value of the depth of the resected cones, receiver operating characteristic (ROC) analysis was performed. Results Negative margins were found in 71.0% (n=49) of all cones, whereas positive margins were reported in 29.0% (n=20). Negative margin cones were achieved in 100% with a cone depth of ≥20 mm. A resection depth between 10-19.9 mm led to 73.0% negative margin cones. Calculation of cone volume shows for 2.0 cm3, a sensitivity of 79% and a specificity of 64%. Statistical analysis using an ROC model showed p=0.002. Conclusion Forth greatest safety of patients, cone depths from LEEPs for cervical dysplasia should be ≥20 mm to achieve negative margins.
Authors and Affiliations
Daniel A. Beyer, Achim Rody, Natalie Schmidt, Christoph Cirkel, Kay Neumann
Congenital central nervous system anomalies: Ten-year single center experience on a challenging issue in perinatal medicine
Objective: Our goal was to highlight the prenatal diagnosis and management of central nervous system (CNS) anomalies through sharing our clinic’s experience. Material and Methods: We evaluated prenatal findings and postn...
Evaluation and comparison of the effects of various cognitive-behavioral therapy methods on climacteric symptoms: A systematic review study
Objective: Climacteric syndrome, which is related to many symptoms, often causes discomfort in women. Non-pharmacologic treatment is one of the treatment options for affected individuals, and this syndrome can be cured w...
Step-by-step colpotomy in total laparoscopic hysterectomy: a technique to avoid apical support damage to the upper vagina
The purpose of this video article is to demonstrate our colpotomy technique that enables maximal protection of the cervical ring, helps to prevent the ureteral injury by distancing, and avoids shortening of the vagina at...
Adnexal lesions after hysterectomy: A retrospective observational study
Objective: To characterize adnexal lesions detected in patients who had undergone previous hysterectomy with one or both ovaries conserved, and to define the clinical, pathologic, and surgical characteristics of the adne...
The effect of the pooling method on the live birth rate in poor ovarian responders according to the Bologna criteria
Objective: Pooling is an alternative method to achieve in vitro fertilization outcomes. This study was to investigate the effect of pooling method on pregnancy outcomes in poor responder patients according to Bologna cri...