Sparić R, Tinelli A, Guido M, Stefanović R, Babović I, Kesić V
Clinic for Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia.
International Translational Medicine and Biomodeling Research Group Department of Applied Mathematics, Moscow Institute of Physics and Technology (State University), Moscow, Russia; Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy of Centre for Interdisciplinary Research Applied to Medicine Department of Obstetrics and Gynecology Vito Fazzi Hospital, Lecce, Italy.
Geburtshilfe Frauenheilkd. 2016 Dec;76(12):1339-1344. doi: 10.1055/s-0042-113773. Epub 2016 Sep 5.
There is insufficient reporting on the level of colposcopic training for the safe use of large loop excision of the transformation zone. The aim of this study was to perform a quality assessment of large loop excision of the transformation zone in women of reproductive age by evaluating the surgeons' colposcopic experience. A retrospective cohort study was performed on diagnostic or therapeutic large loop excision of the transformation zone. The following variables were analyzed: age, parity, indications for surgery, level of surgeon's colposcopic experience, definitive histological diagnosis, margin involvement, and the presence and type of artifacts interfering with the pathological interpretation. Patients were divided into three groups: group A - 75 patients treated by junior colposcopists; group B - 74 patients treated by experienced colposcopists, and group C - 117 patients treated by expert colposcopists. Regarding the presence and diagnostic significance of the artifacts the groups were significantly different. Inadequate samples were the least frequent in group C. Artifacts precluding histological diagnosis were the most common in group A. The margins were predominantly inconclusive in group A. A high rate of artifacts is a disadvantage of the large loop excision of the transformation zone performed by surgeons less skilled for colposcopy. Although large loop excision of the transformation zone is considered to be a minor surgery, skills in colposcopy are an essential prerequisite for optimal results.
关于转化区大环形切除术安全使用的阴道镜培训水平，报告不足。本研究的目的是通过评估外科医生的阴道镜经验，对育龄妇女的转化区大环形切除术进行质量评估。对转化区的诊断性或治疗性大环形切除术进行了一项回顾性队列研究。分析了以下变量：年龄、产次、手术指征、外科医生的阴道镜经验水平、最终组织学诊断、切缘受累情况以及干扰病理解读的伪像的存在和类型。患者分为三组：A组——75例由初级阴道镜检查医生治疗的患者；B组——74例由经验丰富的阴道镜检查医生治疗的患者；C组——117例由专家级阴道镜检查医生治疗的患者。关于伪像的存在及其诊断意义，各组之间存在显著差异。C组中样本不足的情况最少见。妨碍组织学诊断的伪像在A组中最为常见。A组中切缘大多不确定。伪像发生率高是阴道镜操作技能较低的外科医生进行转化区大环形切除术的一个缺点。尽管转化区大环形切除术被认为是一个小手术，但阴道镜检查技能是取得最佳效果的必要前提。
