A multicentric randomized study comparing two techniques of magnification assisted loop excision of high-grade cervical intraepithelial neoplasia: video exoscopy and colposcopy

作者：Vercellino Giuseppe F^*; Erdemoglu Evrim; Chiantera Vito; Malak Al Hakeem; Vasiljeva Katharina; Drechsler Inka; Dueckelmann Anna Maria; Richter Janine; Schneider Achim; Boehmer Gerd

来源：Archives of Gynecology and Obstetrics, 2014, 289(6): 1301-1307.

DOI：10.1007/s00404-013-3134-z

• Colposcopy
• Exoscopy
• LEEP
• Volume removed
• Safety

To compare loop excisions of cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) under video exoscopy, or colposcopic guidance, with respect to safety and effectiveness. %26lt;br%26gt;Prospective multicentric randomized trial of 300 patients, undergoing loop excision for CIN 2+ either under video exoscopy (group A) or colposcope (group B) guidance. Intra- and post-operative complications, resection margins, and removed cervical volume in both groups were evaluated. %26lt;br%26gt;19.3 % of patients in video exoscopy group and 15.5 % in colposcopy group (p = 0.67) had transformation zone (TZ) 3. 45/151 (29.8 %) of group A patients and 48/149 (32.2 %) of group B patients underwent top-hat procedure, i.e., one superficial excision followed by one deeper removal of the endocervical tissue (p = 0.74). There was no difference in intra- and post-operative complications in the two groups. Positive endocervical resection margins (R0) were 9.9 % in video exoscopy group and 8.7 % in colposcopy group, respectively. Unclear endocervical resection margins (Rx) were 2.0 % in both groups. Mean total excised cervical volume was 1.20 cubic centimeter (ccA(3)) in group A, and 1.24 ccA(3) in group B, respectively. Recurrent disease occurred in 2.3 % of patients at 6 months follow-up. %26lt;br%26gt;Magnification assisted loop excision of CIN 2+ is equally effective and safe under colposcopic and video exoscopy guidance. The latter technique could potentially offer an alternative treatment of CIN 2+ lesions for doctors unfamiliar with colposcope.

• 出版日期2014-6