Histological results after large loop excision of the transformation zone procedure: analysis and frequency distribution

Yonka Ivanova; Dimitar Metodiev; Slavcho Tomov; Yavor Kornovski; Stoyan Kostov; Stanislav Slavchev; Angel Yordanov

doi:10.5114/ms.2022.117624

eISSN: 2300-6722
ISSN: 1899-1874

Medical Studies/Studia Medyczne

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2/2022
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abstract:

Original paper

Histological results after large loop excision of the transformation zone procedure: analysis and frequency distribution

Yonka Ivanova

¹

,

Dimitar Metodiev

^{2, 3}

,

Slavcho Tomov

⁴

,

Yavor Kornovski

¹

,

Stoyan Kostov

⁵

,

Stanislav Slavchev

¹

,

Angel Yordanov

⁶

Department of Gynaecology, University Hospital “Saint Anna”, Medical University “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria
Pathology Laboratory, St. Ivan Rilski University Hospital, Sofia, Bulgaria
Histopathology Laboratory, Nadezhda Hospital, Sofia, Bulgaria
University Hospital Saint Marina–Pleven, Medical University Pleven, Pleven, Bulgaria
Department of Gynaecology, University Hospital “Saint Anna”, Varna, Bulgaria
Department of Gynaecologic Oncology, Medical University Pleven, Pleven, Bulgaria

Medical Studies/Studia Medyczne 2022; 38 (2): 109–114

DOI: https://doi.org/10.5114/ms.2022.117624

Online publish date: 2022/06/30

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Introduction
The treatment of precancerous changes in the cervix is the base of secondary prevention of cervical cancer and is a part of most national programs for the prevention of the disease.

Aim of the research
To perform a frequency analysis of histological results after large loop excision of the transformation zone (LLETZ) for cervical precancerous lesions in an outpatient setting.

Material and methods
From 1 January 2017 to 31 July 2021, 189 patients underwent Medical Centre “Prof. Kornovski”. The methodology includes the indications for performing the LLETZ procedure, a description of the procedure, the tools and technical parameters, the operation technique, and the histological examination.

Results
We present a histological analysis of the preparations after LLETZ, the frequency of glandular involvement in the pathological process, the incidence of thermal damage of the resection lines after the procedure, and the incidence of involvement of carcinoma or high-grade squamous intraepithelial lesion of resection lines after LLETZ.

Conclusions
The LLETZ procedure can be diagnostic for the detection of invasive carcinoma in menopausal women, clinically and colposcopically suspected of invasion, but with negative histology from the targeted biopsy. Intra-glandular spread is a sign of high-grade dysplasia and cervical carcinoma in situ. Thermal damage to resection lines is a consequence of LLETZ. These lesions do not compromise the assessment of the resection lines. This shows the possibilities of applying the LLETZ procedure for diagnosing and treating cervical pathologies.

keywords:

large loop excision of the transformation zone, high-grade squamous intraepithelial lesion, intra-glandular involvement, resection lines, histological results

Histological results after large loop excision of the transformation zone procedure: analysis and frequency distribution

Yonka Ivanova 1 , Dimitar Metodiev 2, 3 , Slavcho Tomov 4 , Yavor Kornovski 1 , Stoyan Kostov 5 , Stanislav Slavchev 1 , Angel Yordanov 6

large loop excision of the transformation zone, high-grade squamous intraepithelial lesion, intra-glandular involvement, resection lines, histological results

Yonka Ivanova

¹

,

Dimitar Metodiev

^{2, 3}

,

Slavcho Tomov

⁴

,

Yavor Kornovski

¹

,

Stoyan Kostov

⁵

,

Stanislav Slavchev

¹

,

Angel Yordanov

⁶