Prevalence and Risk Factors for Positive Surgical Margin after Loop Electrosurgical Excision Procedure (LEEP) in Patients with High Grade Squamous Intraepithelial Lesion

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Palaporn Kanjanasirirut
Kamol Pataradool
Sumonmal Manusirivithaya
Chadakarn Phaloprakarn
Chutima Chavanisakun

Abstract

Objective: To determine the prevalence and risk factors for positive surgical margin after LEEP in patients with high grade squamous intraepithelial lesion (HSIL).


Material and Methods: Medical records of all women (n = 575) who underwent LEEP and histopathological diagnosed HSIL between January 2008 and December 2012 in our institution were reviewed. The margins of surgical specimens were re-evaluated by a pathologist. Clinical data and status of surgical margin were recorded. The prevalence and risk factors for positive surgical margin were analyzed.   


Results: Complete data of 547 women with HSIL who underwent LEEP were obtained. Mean age of the women was 41.8 ± 12.5 years (ranging from 17 to 75 years). The majority of them were multiparous (n = 405 or 74.1%) and premenopause (n=464 or 84.8%). Positive LEEP surgical margin was found in 167 cases (30.5 %). In multivariable analysis, multiparity and glandular involvement were two independent risk factors for positive LEEP surgical margin; adjusted relative risk of 8.10 (95% confidence interval, 3.82-17.20) and 14.10 (95% confidence interval, 8.34-23.83), respectively.


Conclusion: The prevalence of positive margin in women with HSIL who underwent LEEP was 30.5 %. Multiparity and glandular involvements were significant factors associated with the margin involvement.

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Kanjanasirirut, P.; Pataradool, K.; Manusirivithaya, S.; Phaloprakarn, C.; Chavanisakun, C. Prevalence and Risk Factors for Positive Surgical Margin After Loop Electrosurgical Excision Procedure (LEEP) in Patients With High Grade Squamous Intraepithelial Lesion. Thai J Obstet Gynaecol 2015, 23, 240-245.
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