Thermal Artifact after Three Techniques of Loop Excision of the Transformation Zone: A Comparative Study

Aims: To compare a surgical-margin thermal artifact in 3 techniques of loop excision of the transformation zone (LETZ). Methods: The histopathologic specimens from 140 patients who underwent 3 techniques of LETZ with different electrosurgical units (large loop used with a Valleylab, large loop used with an Ellman Surgitron, and contoured loop with a Utah Finesse) performed in Rajavithi Hospital between January 2003 and June 2007 were reevaluated by one pathologist with regard to degree and width of diathermy artifact. Results: All of the specimens exhibited thermal tissue artifacts but there were varying degrees of extent and severity. Overall, the mean thermal artifact zone was 0.85 +/- 0.94, 0.57 +/- 0.47, and 0.49 +/- 0.51 mm for the endocervical margin, ectocervical margin, and stromal margin, respectively. However, the thermal artifact did not interfere with the histological diagnosis or the assessment of the margins in all cases. There were no statistical differences in the thermal artifact measurements in the 3 groups. The 3 LETZ techniques provided comparable thermal artifacts in terms of qualitative and quantitative measurement. Conclusions: The thermal artifacts, both in severity and extent, are not significantly different in the 3 LETZ techniques. For routine LETZ in clinical practice, those techniques can be used with a comparable outcome. Copyright (C) 2012 S. Karger AG, Basel