Prevalence and Risk Factor of Incomplete Cervical Excision in Chonburi Hospital

Abstract

Objective:  To determine the prevalence and risk factors of incomplete cervical excision in Chonburi hospital.

Materials and Methods: Descriptive analytical study was conducted in Chonburi Hospital, Thailand. Medical records of patients who had positive (incomplete) cervical margins after loop electrosurgical excision procedure (LEEP) or conization from January 2007 to December 2011 were reviewed.

Results:  There were 2,526 patients undergoing excision procedure and291 patients (11.52%) had positive margins.  One thousand four hundred and fifty one cases (57.44%) underwent conization and 175 cases (42.56%) underwent LEEP. Patient age ranged from 17 to 89 years (mean 41.56 ฑ 13.5 years). Mean body weight and height were 58.28 ฑ 9.5 kg and 153 ฑ 6 cm, respectively. Body mass index ranged from 14.67 to 40.81 kg/m2 (mean 24.88 ฑ 4.4 kg/m2). Ninety two percent were multiparous and sixty eight percent were premenopause. Preoperative cytology was high grade squamous intraepithelial lesion (HSIL) in 1,109 cases (43.9%). Three hundred and fifty nine cases (14.2%) had unsatisfied colposcopic findings. The margin involvement was significantly associated with nulliparity, post menopause, history of HIV, history of smoking, type of the operation, experience of the surgeon, preoperative cytology, unsatisfactory colposcope and preoperative histology.

Conclusion:  The prevalence of a positive cone margin was rather high and depended on population, operativeprocedure, experience of the surgeon, preoperative cytology and histology. Physicians who perform cervical excision should take into account the risk factors in the management of cases with abnormal cytological screening for cervical cancer.