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. 2013 Oct;63(5):332-6.
doi: 10.1007/s13224-012-0332-8. Epub 2013 Mar 26.

LLETZ Specimen Fragmentation: Impact on Diagnosis, Outcome, and Implications for Training

Rasiah Bharathan  1 , Balvinder Sagoo  1 , Aravind Subramaniam  1 , Peter Larsen-Disney  1 , Andrew Fish  1
Affiliations

LLETZ Specimen Fragmentation: Impact on Diagnosis, Outcome, and Implications for Training

Rasiah Bharathan et al. J Obstet Gynaecol India. 2013 Oct.

Abstract

Purpose: This study was designed to assess fragmentation of Large loop excision of the transformation zone (LLETZ) specimens, its influence on short-term cytological outcome, and the risk factors for specimen fragmentation, as we well as trainee performance on clinical outcome.

Method: This retrospective study was performed at a cancer center. Women who underwent LLETZ for suspected high-grade cervical intra-epithelial neoplasia (CIN) over a 5-year period were included. Patients were identified through a regional database. Data were obtained from hospital and regional databases. Fisher's exact test was used.

Results: 75 % of all specimens were obtained intact. When the LLETZ specimen was intact, 89 % of smear tests were reported as negative, against 86 % when the specimen was fragmented. Fragmentation was significantly associated with high-grade smear results at 6 months. Trainee status was significantly related to specimen fragmentation.

Conclusion: Fragmentation of LLETZ specimens is associated with an increased likelihood of obtaining a high-grade smear at 6 months post treatment. Enhancing the colposcopy training may help improve clinical outcome.

Keywords: Colposcopy training; Cytological outcome; LLETZ; Specimen fragmentation.

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