Materials and Method
Medical record review of women who underwent
either LEEP or cold knife conization (CKC) and
subsequently simple hysterectomy at the Department
of Obstetrics and Gynecology, Siriraj Hospital from
January 1999 to December 2003 were performed. A
retrospective review of medical records was conducted
under ethical board review permission. A total of 120
patients who underwent both LEEP or CKC and subsequent
hysterectomy were enrolled in the present study.
All patients had abnormal cervical smears and 117
patients underwent colposcopic examination before the
conization. The indications for conization included
unsatisfactory colposcopy, positive endocervical
curettage, discrepancies of greater than two levels
between Pap smear and colposcopic examination or
suspicion of microinvasive disease(2). Ninety-two
patients underwent LEEP while 28 patients underwent
cold knife conizaton. All conization and LEEP specimens
were fixed in formalin and processed in a standard
fashion. Hysterectomy was performed through
the abdominal route as indicated between 1.5 months
and 12 months after conization. The specimens were
submitted for histopathologic examination including
maximal neoplastic severity, extension to margins and
thermal damage. All histologic slides were reviewed
by a well experienced pathologist at the Department
of Pathology. Residual disease was defined as the
presence of cervical intraepithelial neoplasia or invasive
cancer in the hysterectomy specimens.
Data on patients’ characteristics, previous
cytological report, colposcopic and pathologic finding
were extracted from the medical records. Prevalence
with 95% confidence interval (CI) of residual disease
were calculated. Certain characteristics were compared
between those with and without residual disease to
determine possible risk factors.
Materials and MethodMedical record review of women who underwenteither LEEP or cold knife conization (CKC) andsubsequently simple hysterectomy at the Departmentof Obstetrics and Gynecology, Siriraj Hospital fromJanuary 1999 to December 2003 were performed. Aretrospective review of medical records was conductedunder ethical board review permission. A total of 120patients who underwent both LEEP or CKC and subsequenthysterectomy were enrolled in the present study.All patients had abnormal cervical smears and 117patients underwent colposcopic examination before theconization. The indications for conization includedunsatisfactory colposcopy, positive endocervicalcurettage, discrepancies of greater than two levelsbetween Pap smear and colposcopic examination orsuspicion of microinvasive disease(2). Ninety-twopatients underwent LEEP while 28 patients underwentcold knife conizaton. All conization and LEEP specimenswere fixed in formalin and processed in a standardfashion. Hysterectomy was performed throughthe abdominal route as indicated between 1.5 monthsand 12 months after conization. The specimens weresubmitted for histopathologic examination includingmaximal neoplastic severity, extension to margins andthermal damage. All histologic slides were reviewedby a well experienced pathologist at the Departmentof Pathology. Residual disease was defined as thepresence of cervical intraepithelial neoplasia or invasivecancer in the hysterectomy specimens.Data on patients’ characteristics, previouscytological report, colposcopic and pathologic findingwere extracted from the medical records. Prevalencewith 95% confidence interval (CI) of residual diseasewere calculated. Certain characteristics were comparedbetween those with and without residual disease todetermine possible risk factors.
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