Conservative management of patients with histological incomplete excision of cervical intraepithelial neoplasia after large loop excision of transformation zone

Abstract

To evaluate conservative management of patients with histological incomplete excision of CIN after large loop excision of transformation zone (LLETZ). Two hundred and seventeen patients with high grade CIN were treated with LLETZ from October 1, 1992 to December 31, 1994. Fifty-three patients (24. 4%) had incomplete excision on histology. All patients were followed up cytologically every 3 to 6 months during the first 18 months and then yearly till December 1996. Those patients with positive endocervical margins were followed up with both cervical smear and endocervical smear. The mean follow-up duration was 30. 4 months. Ten patients were found to have persistent or recurrent disease. Five patients had second LLETZ and complete excision was achieved in 4 of them, one patient had cone biopsy and two had hysterectomy. One patient was found to have stage I a cervical cancer. A report of incomplete excision of CIN after LLETZ calls for follow-up with cytology and colposcopy and not aggressive retreatment.