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

IF 2.4 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Lower Genital Tract Disease Pub Date : 2024-01-01 Epub Date: 2023-11-27 DOI:10.1097/LGT.0000000000000784

Min-Jeong Kim, Grace J Lee, Eun Ji Lee, Seungmee Lee, Doo Byung Chay, Chae Hyeong Lee, Jae-Hoon Kim, Ju-Won Roh

{"title":"Lugol's Solution Reduces Positive Margins and Residual Disease After the Large Loop Excision of Transformation Zone.","authors":"Min-Jeong Kim, Grace J Lee, Eun Ji Lee, Seungmee Lee, Doo Byung Chay, Chae Hyeong Lee, Jae-Hoon Kim, Ju-Won Roh","doi":"10.1097/LGT.0000000000000784","DOIUrl":null,"url":null,"abstract":"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.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"12-17"},"PeriodicalIF":2.4000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Lower Genital Tract Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/LGT.0000000000000784","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/27 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

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.

查看原文本刊更多论文

Lugol的解决方案减少了转化区大环切除后的阳性边缘和残留疾病。

目的:本研究旨在探讨术中使用Lugol’s solution是否降低了女性行大环切除术(large loop resection of the transformation zone, LLETZ)的阳性切缘(positive resection margin, RMs)比例。材料和方法:从韩国3所大学医院的每个数据库中回顾性检索总共1751名连续接受LLETZ(有或没有Lugol溶液)的宫颈上皮内瘤变(CIN)妇女。结果包括RMs阳性和LLETZ术后6个月内病理证实的残留疾病。结果:RMs阳性345例(19.7%)。在随访的1507名妇女中，残留病变100例(6.6%)(69/308例RMs阳性;31/ 1199例RMs阴性)。Lugol溶液组出现阳性RMs (11.8% vs 25.5%， p < 0.01)、需要额外手术干预(5.4% vs 10.2%， p < 0.01)和残留疾病(4.9% vs 8.0%， p = 0.02)的可能性较小。在多元logistic回归分析中，Lugol溶液降低了正RMs的比例(调整优势比[aOR]， 0.31)。年龄(50岁以上);aOR, 1.64)、宫颈细胞学预圆锥化(aOR, 1.53)、高危人乳头瘤病毒(aOR, 1.75)和CIN 2或3 (aOR, 2.65)是切缘阳性的独立危险因素(除高危人乳头瘤病毒(p = 0.05)外，其他因素均< 0.01)。结论:Lugol溶液通过降低LLETZ后RMs阳性比例和残留疾病比例，优化了CIN的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Lower Genital Tract Disease OBSTETRICS & GYNECOLOGY-

CiteScore

6.80

自引率

8.10%

发文量

158

审稿时长

6-12 weeks

期刊介绍： The Journal of Lower Genital Tract Disease is the source for the latest science about benign and malignant conditions of the cervix, vagina, vulva, and anus. The Journal publishes peer-reviewed original research original research that addresses prevalence, causes, mechanisms, diagnosis, course, treatment, and prevention of lower genital tract disease. We publish clinical guidelines, position papers, cost-effectiveness analyses, narrative reviews, and systematic reviews, including meta-analyses. We also publish papers about research and reporting methods, opinions about controversial medical issues. Of particular note, we encourage material in any of the above mentioned categories that is related to improving patient care, avoiding medical errors, and comparative effectiveness research. We encourage publication of evidence-based guidelines, diagnostic and therapeutic algorithms, and decision aids. Original research and reviews may be sub-classified according to topic: cervix and HPV, vulva and vagina, perianal and anal, basic science, and education and learning. The scope and readership of the journal extend to several disciplines: gynecology, internal medicine, family practice, dermatology, physical therapy, pathology, sociology, psychology, anthropology, sex therapy, and pharmacology. The Journal of Lower Genital Tract Disease highlights needs for future research, and enhances health care. The Journal of Lower Genital Tract Disease is the official journal of the American Society for Colposcopy and Cervical Pathology, the International Society for the Study of Vulvovaginal Disease, and the International Federation of Cervical Pathology and Colposcopy, and sponsored by the Australian Society for Colposcopy and Cervical Pathology and the Society of Canadian Colposcopists.