Efficacy and safety of large-loop excision of the transformation zone.

Large-loop excision of the transformation zone (LLETZ) has become a popular treatment for women with cervical intraepithelial neoplasia (CIN) before long-term effectiveness and safety have been fully evaluated. Women who took part in a 1990 study of the procedure have been followed-up by cervical cytology for longer than 2 years. The rate of recurrences and residual lesions was 5.0% in the first year and 0.6% in the second year. LLETZ was also effective when used as a repeat procedure, although the negative histology rate was much higher (4.7% for initial procedures and 20% for repeat procedures). 250 women from the original study group of 1000 answered a questionnaire on fertility and menstrual symptoms 3 years after LLETZ. We found no differences between these women and controls of the same age, living in the same geographical area, with a history of negative cervical smears. LLETZ is a safe and effective procedure with no effect on menstruation or fertility.