Therapeutic Effectiveness of Large Loop Excision of Transformation Zone (LLETZ) in Management of Cervical Lesions

Abstract

LLETZ is a simple, outpatient means of removing the transformation Zone or morbidity to the patient. The aim of our study was to evaluate the therapeutic effectiveness of LLETZ in management of cervical lesions. This prospective study was conducted at Department obstetrics and Gynecology Zenana Hospital, SMS Medical College, Jaipur from December 2014 to June 2015. The study includes all patients who attended colposcopy clinic with complaints of persistent leucorrhea, postcoital bleeding, intermenstrual bleeding and postmenopausal bleeding. We had 29 cases of chronic endocervicitis, 27 showed an inflammatory smear while 2 showed LGSIL. 3 patients showing HGSIL on pap smear showed CIN I on histopathology. This was false positive of Pap smear (6%). 1 patient of invasive squamous cell carcinoma showed HGSIL on pap smear. Thus LEEP was useful in diagnosing a case of invasive carcinoma which would have been missed with Pap smear alone. Also 3 patients of CIN II on biopsy had inflammatory (1) and LGSIL (2) on pap smear. LEEP (Loop Electrosurgical Excision Procedure) is a feasible management strategy for cervical lesions especially in developing countries like India where incidence of cervical carcinoma remains high because of ineffective screening and poor patient compliance for follow up.