For a study, researchers sought to determine the effectiveness and long-term result of repeat large loop excision of the transformation zone in women with residual or recurrent cervical intraepithelial neoplasia. The Dutch Pathology Registry (PALGA), a database of deidentified cervical cytologic and histologic data, was utilized to study women with cervical dysplasia who had two or more large loop excisions of the transformation zone surgeries between January 2005 and June 2015. Cervical cytology and histology findings were obtained. The key outcome was the effectiveness of the transformation zone procedure’s repeated big loop excision in women with residual or recurrent cervical intraepithelial neoplasia. Following excisional surgeries and hysterectomy were also investigated.

Researchers found 499 women who had had two or more big loop excision surgeries of the transition zone. 60.7% of women had a normal initial cervical cytologic sample following their second operation. The average time between visits was 68 months (0–163 months). 33.7% of women had further cervical excisional surgeries. During the study’s follow-up period, 1.2% of the women had cervical cancer. Furthermore, 19.% of women had a hysterectomy at some point.

One-third of women who have two big loop excisions of the transformation zone require a third excisional operation or hysterectomy. A hysterectomy was subsequently performed on about one-fifth of the women. 

Reference:journals.lww.com/greenjournal/Fulltext/2022/03000/Efficacy_and_Long_term_Outcomes_of_Repeated_Large.9.aspx

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