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Outpatient loop diathermy cone biopsy

1993; Informa; Volume: 13; Issue: 2 Linguagem: Inglês

10.3109/01443619309151801

1364-6893

Paul Byrne, Onome Ogueh, J. Frank Wilson, L. J. Sant‐Cassia,

Endometrial and Cervical Cancer Treatments

SummaryThe aim of the study was to determine the efficacy and morbidity of outpatient cone biopsy using large loop diathermy in women with abnormal cervical smears for whom local destructive therapy was contraindicated. A prospective programme trial with 12 months follow up is reported.One hundred patients aged 20 to 69 years with abnormal cervical smears in whom local destructive therapy was inappropriate were treated by large loop cone biopsy under local anaesthesia as an outpatient procedure. Histological examination of the tissue obtained revealed no abnormality in eight cases, koilocytosis alone in three cases, CIN 1 in 14, CIN 2 in 24, CIN 3 in 44, micro-invasive squamous carcinoma in five, invasive squamous carcinoma in one and adenosquamous carcinoma in one case. The mean length of the cone specimens was 11 cm (range 0-5-2-0). Excision margins were free of disease in 73 cases. Immediate morbidity following the procedure was minimal. Secondary haemorrhage occurred in two cases. Follow up data were available for 93 patients; 78 had negative cervical cytology at the first follow up assessment (mean 5-2, range 3-8 months), 86 had negative cytology at the second follow up visit (mean II I, range 8-16 months). Despite the high rate of incomplete excision of disease, outpatient cone biopsy using loop diathermy is an effective treatment for patients with abnormal cervical smears in whom local destructive therapy is contraindicated and is an alternative to knife cone biopsy under general anaesthesia.