A Trial of Two Electrosurgical Conizations: Histopathological Analysis of Excision Margins
A Trial of Two Electrosurgical Conizations: Histopathological Analysis of Excision Margins
The purpose of this trial is to evaluate if Straight Wire Excision of the Transformation Zone
 (SWETZ) is superior to (Large Loop Excision of the Transformation Zone) LLETZ cone in
 reducing the incomplete excision of disease.
Cone biopsy is a surgical procedure which objectives the excision of endocervical
 pre-invasive disease located at transformation zone or glandular epithelium. Although cone
 biopsy is considered adequate for the treatment of endocervical dysplastic epithelium , using
 electrosurgery as opposed to the cold knife technique of cone biopsy has been criticized
 because of the perceived potential for incomplete excision of disease, thermal damage and
 surgical specimen fragmentation, which might increase the risk of missing early invasive
 cancer. Also, incomplete excision margin of disease exposes women to an increased risk of
 residual post-treatment disease.

 The standard procedure, Large Loop Excision of the Transformation Zone (LLETZ-cone), is
 performed with a large loop electrode of 20-25 mm depth.

 The experimental intervention is Straight Wire Excision of the Transformation Zone (SWETZ), a
 method of excision using a 1cm straight disposal of 0.20 wire to remove the endocervical
 transformation zone or glandular disease.

 Both procedures were previously studied in another clinical trial(NCT00995020), but the
 histological analysis were inconclusive for many outcomes. SWETZ were superior to LLETZ cone
 to acquire complete excision of disease, with no statistical significance, probably due to
 the small sample size.

 This study objectives a better histological analyses of the surgical specimens related to
 incomplete excision, thermal damage and fragmentation.
Inclusion Criteria:

 -  Patients were eligible if the colposcopist decided that a cone biopsy was indicated.

 -  Common indications for a cone biopsy included:

 -  High-grade Squamous Intraepithelial Lesion in a type 3 transformation zone,

 -  suspicion of micro-invasive or invasive carcinoma and

 -  suspicion of glandular disease.

 Exclusion Criteria:

 -  Patients were excluded if pregnancy, coagulation disorders and cervicitis were present
 or if they refused to participate in the study.