"See-and-treat" loop electrosurgical excision. Has the time come for a reassessment?
J Reprod Med
; 47(7): 569-74, 2002 Jul.
Article
en En
| MEDLINE
| ID: mdl-12170535
ABSTRACT
OBJECTIVE:
To review the results of a policy decision to offer selected women with cervical high grade squamous intraepithelial lesions (HSILs) loop electrosurgical excision (LEEP) at the time of their initial colposcopic evaluation. STUDYDESIGN:
Sixty-one patients with newly diagnosed cytologic cervical HSIL were evaluated for inclusion in a "see-and-treat" protocol. Fifty of these patients met inclusion criteria and underwent immediate loop excision of the cervical transformation zone at their initial colposcopic visit.RESULTS:
Forty-eight of 50 patients that underwent see-and-treat management at their initial colposcopic evaluation had histologic evidence of cervical dysplasia/neoplasia. The positive predictive value of diagnostic colposcopy in this setting was 96%, with a 95% confidence interval (88-99%). Two patients had no pathologic abnormality, for an overtreatment incidence of 4%.CONCLUSION:
The selected use of see-and-treat management of cytologic cervical HSIL is feasible, highly predictive and associated with an extremely low incidence of overtreatment. Such management has the potential to increase patient satisfaction and compliance while drastically reducing health care dollars currently directed toward the management of HSIL. Strong consideration should be given to accepting see-and-treat management as a viable alternative in the care of patients with documented cervical cytologic HSIL.
Search on Google
Banco de datos:
MEDLINE
Asunto principal:
Pautas de la Práctica en Medicina
/
Carcinoma de Células Escamosas
/
Displasia del Cuello del Útero
/
Neoplasias del Cuello Uterino
/
Colposcopía
/
Electrocirugia
Tipo de estudio:
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
País como asunto:
America do norte
Idioma:
En
Año:
2002
Tipo del documento:
Article