Electrosurgical loop excision of the cervical transformation zone

The experience of family physicians

Daron Gale Ferris, B. L. Hainer, J. L. Pfenninger, T. J. Zuber, D. E. DeWitt, R. L. Line

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background. Electrosurgical loop excision of the cervical transformation zone (ELECTZ) is an excisional surgical procedure for treatment of premalignant cervical disease and the abnormal transformation zone by wire loop electrodes. The purpose of this study was to describe and assess the clinical experiences and complications of family-physician-performed ELECTZ and ELECTZ conization. Methods. Women who were scheduled for the ELECTZ or ELECTZ conization procedures were enrolled in the study between March 1992 and March 1993, inclusive. Subjects were recruited from the practices of six family physician colposcopists located at five sites. The ELECTZ and ELECTZ conization procedures were performed on patients with abnormal Papanicolaou (Pap) smears or abnormal histologic results and abnormal colposcopic findings. Procedural complications were documented. Subjects were serially assessed during the first postoperative year by Pap smears, colposcopy, and, when necessary, by biopsy to determine therapeutic cure. Results. Of 198 subjects enrolled in the study, 148 women were assessed at least once in follow-up by Pap smear and colposcopy. Only 7.6% of women were defined as treatment failures by subsequent histologic assessment. Women treated by ELECTZ conization were older (32.2 vs 25.1 years, P=.02), were more likely to develop posttreatment cervical stenosis (25.9% vs 3.8%, P=.001), and were more likely to have the postoperative squamocolumnar junction positioned in the endocervical canal (32.4% vs 8.7%, P=.002) than were women treated by ELECTZ. Loop excision specimen margins demonstrated dysplasia for 27 (13.6%) subjects. Significant operative bleeding (>25 mL) was noted in 6.8% of subjects. Histologic thermal artifact was reported for 9.6% of specimens. One case of microinvasive cancer and one case of invasive cancer were identified unexpectedly by ELECTZ conization. Conclusions. Electrosurgical loop excision of the cervical transformation zone and ELECTZ conization may be safely and effectively performed in office settings by family physicians. Complications and treatment failure rates for the ELECTZ and ELECTZ conization procedures were similar to those experienced by other clinicians.

Original languageEnglish (US)
Pages (from-to)337-344
Number of pages8
JournalJournal of Family Practice
Volume41
Issue number4
StatePublished - Jan 1 1995

Fingerprint

Conization
Family Physicians
Papanicolaou Test
Colposcopy
Treatment Failure
Artifacts
Neoplasms
Electrodes
Pathologic Constriction
Hot Temperature
Hemorrhage
Biopsy
Therapeutics

Keywords

  • cervical intraepithelial neoplasia
  • Electrosurgery
  • primary health care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Ferris, D. G., Hainer, B. L., Pfenninger, J. L., Zuber, T. J., DeWitt, D. E., & Line, R. L. (1995). Electrosurgical loop excision of the cervical transformation zone: The experience of family physicians. Journal of Family Practice, 41(4), 337-344.

Electrosurgical loop excision of the cervical transformation zone : The experience of family physicians. / Ferris, Daron Gale; Hainer, B. L.; Pfenninger, J. L.; Zuber, T. J.; DeWitt, D. E.; Line, R. L.

In: Journal of Family Practice, Vol. 41, No. 4, 01.01.1995, p. 337-344.

Research output: Contribution to journalArticle

Ferris, DG, Hainer, BL, Pfenninger, JL, Zuber, TJ, DeWitt, DE & Line, RL 1995, 'Electrosurgical loop excision of the cervical transformation zone: The experience of family physicians', Journal of Family Practice, vol. 41, no. 4, pp. 337-344.
Ferris, Daron Gale ; Hainer, B. L. ; Pfenninger, J. L. ; Zuber, T. J. ; DeWitt, D. E. ; Line, R. L. / Electrosurgical loop excision of the cervical transformation zone : The experience of family physicians. In: Journal of Family Practice. 1995 ; Vol. 41, No. 4. pp. 337-344.
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title = "Electrosurgical loop excision of the cervical transformation zone: The experience of family physicians",
abstract = "Background. Electrosurgical loop excision of the cervical transformation zone (ELECTZ) is an excisional surgical procedure for treatment of premalignant cervical disease and the abnormal transformation zone by wire loop electrodes. The purpose of this study was to describe and assess the clinical experiences and complications of family-physician-performed ELECTZ and ELECTZ conization. Methods. Women who were scheduled for the ELECTZ or ELECTZ conization procedures were enrolled in the study between March 1992 and March 1993, inclusive. Subjects were recruited from the practices of six family physician colposcopists located at five sites. The ELECTZ and ELECTZ conization procedures were performed on patients with abnormal Papanicolaou (Pap) smears or abnormal histologic results and abnormal colposcopic findings. Procedural complications were documented. Subjects were serially assessed during the first postoperative year by Pap smears, colposcopy, and, when necessary, by biopsy to determine therapeutic cure. Results. Of 198 subjects enrolled in the study, 148 women were assessed at least once in follow-up by Pap smear and colposcopy. Only 7.6{\%} of women were defined as treatment failures by subsequent histologic assessment. Women treated by ELECTZ conization were older (32.2 vs 25.1 years, P=.02), were more likely to develop posttreatment cervical stenosis (25.9{\%} vs 3.8{\%}, P=.001), and were more likely to have the postoperative squamocolumnar junction positioned in the endocervical canal (32.4{\%} vs 8.7{\%}, P=.002) than were women treated by ELECTZ. Loop excision specimen margins demonstrated dysplasia for 27 (13.6{\%}) subjects. Significant operative bleeding (>25 mL) was noted in 6.8{\%} of subjects. Histologic thermal artifact was reported for 9.6{\%} of specimens. One case of microinvasive cancer and one case of invasive cancer were identified unexpectedly by ELECTZ conization. Conclusions. Electrosurgical loop excision of the cervical transformation zone and ELECTZ conization may be safely and effectively performed in office settings by family physicians. Complications and treatment failure rates for the ELECTZ and ELECTZ conization procedures were similar to those experienced by other clinicians.",
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AU - Zuber, T. J.

AU - DeWitt, D. E.

AU - Line, R. L.

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N2 - Background. Electrosurgical loop excision of the cervical transformation zone (ELECTZ) is an excisional surgical procedure for treatment of premalignant cervical disease and the abnormal transformation zone by wire loop electrodes. The purpose of this study was to describe and assess the clinical experiences and complications of family-physician-performed ELECTZ and ELECTZ conization. Methods. Women who were scheduled for the ELECTZ or ELECTZ conization procedures were enrolled in the study between March 1992 and March 1993, inclusive. Subjects were recruited from the practices of six family physician colposcopists located at five sites. The ELECTZ and ELECTZ conization procedures were performed on patients with abnormal Papanicolaou (Pap) smears or abnormal histologic results and abnormal colposcopic findings. Procedural complications were documented. Subjects were serially assessed during the first postoperative year by Pap smears, colposcopy, and, when necessary, by biopsy to determine therapeutic cure. Results. Of 198 subjects enrolled in the study, 148 women were assessed at least once in follow-up by Pap smear and colposcopy. Only 7.6% of women were defined as treatment failures by subsequent histologic assessment. Women treated by ELECTZ conization were older (32.2 vs 25.1 years, P=.02), were more likely to develop posttreatment cervical stenosis (25.9% vs 3.8%, P=.001), and were more likely to have the postoperative squamocolumnar junction positioned in the endocervical canal (32.4% vs 8.7%, P=.002) than were women treated by ELECTZ. Loop excision specimen margins demonstrated dysplasia for 27 (13.6%) subjects. Significant operative bleeding (>25 mL) was noted in 6.8% of subjects. Histologic thermal artifact was reported for 9.6% of specimens. One case of microinvasive cancer and one case of invasive cancer were identified unexpectedly by ELECTZ conization. Conclusions. Electrosurgical loop excision of the cervical transformation zone and ELECTZ conization may be safely and effectively performed in office settings by family physicians. Complications and treatment failure rates for the ELECTZ and ELECTZ conization procedures were similar to those experienced by other clinicians.

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