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  • Trabalhos Originais

    Loop electrosurgical excision procedure and colposcopic localization of the atypical cervical epithelium

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(6):349-354

    Summary

    Trabalhos Originais

    Loop electrosurgical excision procedure and colposcopic localization of the atypical cervical epithelium

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(6):349-354

    DOI 10.1590/S0100-72032001000600002

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    Purpose: to evaluate the histopathologic results of cone specimens of patients undergoing loop electrosurgical excision procedure (LEEP) and their relationship with the localization of the lesion. Methods: in a retrospective study, 134 clinical reports of patients with abnormal findings of cervical cytology and/or biopsy undergoing LEEP were reviewed. The colposcopic findings were divided into three groups according to the localization of the lesion. Group I (n = 36): patients with ectocervical lesions and fully visible squamocolumnar junction; Group II (n = 50): patients with lesions at the ectocervix and endocervix, and Group III (n = 48): patients with unsatisfactory colposcopy. Results: the mean age in Group I was 33 years and there were 8.3% positive margins. In Group II the mean age was 39 years, with 36% positive margins. Group III had a mean age of 48 years and presented 29.2% positive margins. The percentage of residual disease was 4.2% in Group I, 31.6% in Group II and 35.5% in Group III. Conclusion: patients with lesions at the endocervical canal showed a higher rate of positive margins. Patients with high-grade cervical intraepithelial neoplasia at the endocervical canal and older than 40 years have a greater chance of showing positive margins and residual disease, therefore requiring stricter cytologic and colposcopic follow-up.

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  • Trabalhos Originais

    Evaluation of the Intensity and the Extension of Thermal Alterations Produced by High Frequency Surgery in the Uterine Cervix

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(1):47-51

    Summary

    Trabalhos Originais

    Evaluation of the Intensity and the Extension of Thermal Alterations Produced by High Frequency Surgery in the Uterine Cervix

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(1):47-51

    DOI 10.1590/S0100-72032001000100007

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    Purpose: to evaluate the incidence of thermal damage to the specimens excised through large loop excision of the transformation zone (LLETZ) and to determine qualitatively and quantitatively the thermal injury to the ectocervical and endocervical epithelia as well as the influence of the menstrual phase on such process. Methods: we performed a prospective study of 100 patients with high-grade squamous intraepithelial lesions (HGSIL). Thermal damage was subdivided into three grades according to Messing et al¹. Results: thermal injury occurred in all the cases, however, through statistical analysis we found that in 91% of the cases it was insignificant, thus leading to a precise histological evaluation, hence to measure the thermal injury was unnecessary. The grade and extent of thermal damage in excised specimens using LLETZ had no relation to the menstrual phase. The extension of thermal tissue alteration in the endocervical epithelia was 271,6 mu while the extension in ectocervical epithelia was 254,8 mu, showing that the extension of thermal damage is significantly higher in endocervical epithelia. Of the one hundred patients, 80 were in menacme and 20 in menopause correlating the grade and extension of thermal damage with the menstrual state. Conclusion: there was no significant difference in both qualitative and quantitative evaluations. There is no need to measure the thermal damage.

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