Comparison of Success Rate and Complications of Contour-Loop Excision of the Transformation Zone (C-LETZ) with Cold Knife Conization (CKC) in High Grade Lesion (HGL) from Colposcopic Impression
Manop Janthanaphan MD*, Virach Wootipoom MD*, Kobkul Tangsinmunkong MD**, Tippawan Liabsuetrakul MD, PhD***
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand ** Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand *** Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand
Objective : To compare the complications and success rate of Contour-Loop Excision of the Transformation
Zone (C-LETZ) with Cold Knife Conization (CKC) in High Grade Lesion (HGL).
Material and Method: Between April 1st, 2007 and November 30th, 2007, forty-five C-LETZs were performed in
patients who had Pap smear result of High grade Squamous Intraepithelial Lesion (HSIL) or Squamous Cell
Carcinoma (SCC) combined with colposcopic impression of satisfactory HGL by using the “See and Treat”
approach. Success rate, tissue size, operating time, blood loss, intra-operative, and post-operative complications
(2 weeks) were recorded to compare with the retrospective results from therapeutic CKC.
Results : Forty-five cases of C-LETZ and 50 cases of CKC were compared. Using the “See and Treat” approach,
the over-treatment rate was 6.7% (3/45). The success rate and tissue size were not different between both
groups. The operating time, blood loss, and post-operative infection were significantly less in the C-LETZ
group.
Conclusion : The authors compared CKC with C-LETZ, which is a new method for the management of HGL of
the cervix and found C-LETZ to be a favorable method with comparable efficacy but with significantly less
morbidity, and suitable as a “See and Treat” method in a hospital outpatient clinic.
Keywords : Cold knife conization, CKC, Contour loop excision of the transformation zone, C-LETZ, Cervical intraepithelial neoplasia, Treatment outcome, Postoperative complications
