Loop electrosurgical excision procedure combined with cold coagulation for cervical intraepithelial neoplasia and adenocarcinoma in-situ: a feasible treatment with a low risk of residual/recurrent disease

Lugol's Solution Reduces Positive Margins and Residual Disease After the Large Loop Excision of Transformation Zone

OBJECTIVE

This study aimed to examine whether the intraoperative use of Lugol's solution reduces the proportion of positive resection margins (RMs) using the data of women who underwent large loop excision of the transformation zone (LLETZ).

MATERIALS AND METHODS

A total of 1,751 consecutive women with cervical intraepithelial neoplasia (CIN) who underwent LLETZ with or without Lugol's solution were retrospectively retrieved from each database of 3 university hospitals in South Korea. Outcomes included positive RMs and residual disease pathologically confirmed within 6 months after LLETZ.

RESULTS

Positive RMs were noted in 345 cases (19.7%). Among 1,507 women followed up, residual disease was diagnosed in 100 cases (6.6%) (69/308 cases with positive RMs; 31/1,199 cases with negative RMs). The Lugol's solution group was less likely to have positive RMs (11.8% vs 25.5%, p < .01), to require additional surgical intervention (5.4% vs 10.2%, p < .01), and to have residual disease (4.9% vs 8.0%, p = .02). On multiple logistic regression analysis, Lugol's solution reduced the proportion of positive RMs (adjusted odds ratio [aOR], 0.31). Age (50 years or older; aOR, 1.64), preconization cervical cytology (aOR, 1.53), high-risk human papillomavirus (aOR, 1.75), and CIN 2 or 3 (aOR, 2.65) were independent risk factors for margin positivity ( p < .01 for all except high-risk human papillomavirus of p = .05).

CONCLUSIONS

Lugol's solution optimizes CIN treatment by reducing the proportion of positive RMs and residual disease after LLETZ.

Wound-Healing on Minimally Invasive Systems with Micro-Arc Oxidized (MAO) and Acid-Etched (SLA) Surface Modifications in Finite Element Liver Model

The purpose of this research is to study micro-arc oxidation (MAO) and acid etching (SLA) in the liver after minimally invasive treatment. The three-dimensional (3D) liver model is rebuilt by magnetic resonance imaging (MRI) to simulate the clinical process. The processing layer is an important factor in clinical applications. Several studies have investigated the finite element model of the liver; however, few people have studied the equipment model with treated layers. The results revealed that temperature was significantly decreased when devices using MAO and SLA thin films. In addition, the SLA treatment group showed a relatively low temperature, which was 12.88% lower. It is an effective means to reduce abnormally thermal injury and lateral thermal area. The present study reveals that the novel nanostructured thin film on electrosurgery devices is an effective means of improving the performance of reducing over thermal injury and uniformly distributing temperature in livers.