Direct colposcopic vision used with the LLETZ procedure for optimal treatment of CIN: results of joint cohort studies

Purpose To assess the value of direct colposcopic vision (DCV) for optimizing large loop excision of the transformation zone (LLETZ) for the treatment of cervical intraepithelial neoplasia (CIN). Methods Data from 648 patients who underwent excisional procedures for CIN and were included in two previously published cohort studies were retrospectively reviewed. Women who had a LLETZ were included for analysis ( n = 436). Margin status, surgical specimen dimensions and volume were analysed according to the use of colposcopy during procedure. Results Compared to LLETZ guided by previous colposcopy report only, and to LLETZ performed immediately after colposcopy, DCV allowed for a significantly higher rate of clear margins: 33 (52.4 %), 104 (68.0 %) and 142 (84.5 %), respectively ( p