Spray Versus Forced Coagulation in Large Loop Excision of the Transformation Zone: A Randomized Trial

Journal of Lower Genital Tract Disease
Ziad HilalClemens B Tempfer

Abstract

Large loop excision of the transformation zone (LLETZ) is the standard surgical treatment for cervical dysplasia. The optimal way to achieve local hemostasis in women undergoing LLETZ is unknown. In a prospective, randomized trial, we compared spray coagulation and forced coagulation in women undergoing LLETZ in a 1:1 ratio. The primary endpoint was time to complete local hemostasis (TCLH). Secondary endpoints were blood loss (Δ hemoglobin before and after LLETZ), pain (numerical visual analog scale, 5-step graphical visual analog scale measured 2-3 hours after LLETZ), and perioperative/postoperative complications (intraoperative need for sutures, postoperative bleeding, infection, and unscheduled readmission). Analysis was by intention to treat. One hundred fifty-one women were enrolled and were eligible for analysis. Mean (SD) TCLH in 80 women with forced coagulation was 43.3 (38.5) and 28.9 (22.9) seconds in 71 women with spray coagulation (p < 0.001). The secondary endpoints blood loss (Δ hemoglobin, -0.8 [0.8] vs -0.7 [1.1]; p = 0.115), pain (numerical visual analog scale, 4.1 [0.9] vs 4.2 [0.9]; p = 0.283, graphical visual analog scale (1.9 [1.3] vs 1.8 [1.3]; p = 0.888), and perioperative/postoperative complications (6/7...Continue Reading

References

Sep 10, 2005·Best Practice & Research. Clinical Obstetrics & Gynaecology·B G Lindeque
Feb 17, 2010·BJOG : an International Journal of Obstetrics and Gynaecology·S V PhadnisP G Walker
Feb 24, 2015·Journal of Clinical Medicine Research·Aristoteles Mauricio Garcia RamosRicardo Bueno de Rezende

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Citations

Dec 5, 2013·The Cochrane Database of Systematic Reviews·Pierre P L Martin-Hirsch, Andrew Bryant
Jun 26, 2020·American Journal of Obstetrics and Gynecology·Günther A RezniczekZiad Hilal

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