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

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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 (cc³) in group A, and 1.24 cc³ in group B, respectively. Recurrent disease occurred in 2.3 % of patients at 6 months follow-up.

Conclusion

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

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Conflict of interest

Achim Schneider acts as advisor for Karl Storz, GSK and Sanofi Pasteur. He received honoraria for lectures.

Author information

Authors and Affiliations

  1. Department of Gynecology, Campus Benjamin Franklin, Charité, Hindenburgdamm 30, 12200, Berlin, Germany

    Giuseppe F. Vercellino, Vito Chiantera, Al-Hakeem Malak, Anna Maria Dückelmann, Janine Richter & Achim Schneider

  2. Department of Gynecology and Gynecologic Oncology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey

    Evrim Erdemoglu

  3. Gynecology Department, King Saud University Medical College, Riyadh, Saudi Arabia

    Al-Hakeem Malak

  4. Department of Gynecology, Campus Charité Mitte, Charité, CharitéPlatz 1, 10117, Berlin, Germany

    Katharina Vasiljeva, Inka Drechsler & Achim Schneider

  5. Colposcopy Clinic Wagner Stibbe, Hannoversche Str. 24, 31848, Bad Münder, Germany

    Gerd Böhmer

Authors
  1. Giuseppe F. Vercellino
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  2. Evrim Erdemoglu
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  3. Vito Chiantera
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  4. Al-Hakeem Malak
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  5. Katharina Vasiljeva
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  6. Inka Drechsler
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  7. Anna Maria Dückelmann
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  8. Janine Richter
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  9. Achim Schneider
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  10. Gerd Böhmer
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Corresponding authors

Correspondence to Giuseppe F. Vercellino or Evrim Erdemoglu.

Additional information

We dedicate this article to Anneliese Jähn 1932–2012 who dedicated her professional career to the prevention of cervical cancer at Charité University Medicine, Berlin, Germany.

All authors have contributed to the manuscript.

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Vercellino, G.F., Erdemoglu, E., Chiantera, V. et al. A multicentric randomized study comparing two techniques of magnification assisted loop excision of high-grade cervical intraepithelial neoplasia: video exoscopy and colposcopy. Arch Gynecol Obstet 289, 1301–1307 (2014). https://doi.org/10.1007/s00404-013-3134-z

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  • DOI: https://doi.org/10.1007/s00404-013-3134-z

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