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Inpatient and outpatient loop electrosurgery excision procedure for cervical intraepithelial neoplasia: a retrospective analysis

Leimbacher, B. ; Samartzis, N. ; Imesch, P. ; Dedes, K. ; Fink, D. ; Canonica, C.

In: Archives of Gynecology and Obstetrics, 2012, vol. 285, no. 5, p. 1441-1445

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    Title
    • Inpatient and outpatient loop electrosurgery excision procedure for cervical intraepithelial neoplasia: a retrospective analysis
    Author
    • Leimbacher, B.. Department of Gynecology, University Hospital of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Samartzis, N.. Department of Gynecology, University Hospital of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Imesch, P.. Department of Gynecology, University Hospital of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Dedes, K.. Department of Gynecology, University Hospital of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Fink, D.. Department of Gynecology, University Hospital of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Canonica, C.. Department of Gynecology, University Hospital of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Archives of Gynecology and Obstetrics, 2012, vol. 285, no. 5, p. 1441-1445. Springer-Verlag
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:310317
    Summary
    Purpose: To determine whether the outpatient loop electrosurgical excision procedure (LEEP) conization (out-LEEP) is as effective and safe as inpatient LEEP conization (in-LEEP) with regard to the complete removal of cervical dysplasia, recurrence-free survival and post-operative morbidity. Methods: 233 patients were included in this retrospective cohort study from January 2002 to December 2007. 181 had outpatient treatment and 52 inpatient treatment. We used Mann-Whitney U test, two-sided Fisher's exact test, Chi-square test, log rank test and Kaplan-Meier curve. Results: Incomplete excision was found in 16/52 (30.8%) cases in the inpatient group and 46/181 (25.4%) in the outpatient group (P=0.48). Six patients had post-operative complications: two cases of secondary haemorrhage in each group (in-LEEP 3.8%, out-LEEP 1.1%, P=0.22) and two cases of cervical stenosis amongst inpatients (3.8%, P=0.049). Alteration of specimen by thermal artifact were reported in 4/52 (7.7%) of in-LEEP cones and 10/181 (5.5%) of out-LEEP cones (P=0.52). Measurements of cones in both groups were comparable with a mean depth of 9.35mm (±5.5mm) and 8.4mm (±3.4mm), respectively. Conclusion: Our results suggest that efficacy and safety of ambulatory LEEP conization is comparable as in inpatient procedure