Avaliação da eficácia da cirurgia de alta freqüência no tratamento primário de lesões intra-epiteliais cervicais de alto grau

Abstract

Objective: to evaluate the efficacy of the Large Loop Excision of the Transformation Zone (LLETZ) in the primary treatment of cervical intraepithelial neoplasia of high grade after 12 months. Patients and methods: prospective clinical study in which were analyzed 66 women submitted to the conning of the uterine cervix through diathermal handle, between February 2003 and February 2005, at the Clinic of Women Reference Service (Ambulatório do Serviço de Referência da Mulher), of Contagem county, Minas Gerais. Were included in the study only women who returned to the clinic at three, six and 12 months after surgery and in whose surgical species cervical intra-epithelial neoplasia of high grade has been detected. In all appointments colposcopy and biopsy were made whenever necessary, having all the patients with return of the cervical intra-epithelial neoplasia been submitted to specific treatment. To statistic use, associations were evaluated through the Qui-Quadrado test of Pearson, Kolmogorov-Smirnov test, Fisher test and Mann-Whitney test. Results: The minimum age observed in the sample was 18 years old and the maximum was 59 years old. The prevalence of the return was greater in the sixth month after LLETZ. There had been association between the surgical margins and the return only in the third month of sequence. Such association was not verified at six and 12 months. In this sample, only the variable age influenced in the return of cervical intraepithelial neoplasia, meanwhile tobaccoism and the use of oral contraceptive were not factors that influenced the return. The women who have free margin possess 93% less chance of presenting return in the period of one year. To women with compromised margin, the chance of having return increases to 4% with the increase of one year in the patient´s age. Conclusion: LLETZ, as a primary treatment for high grade lesions, presented an effectiveness of 66, 7% in a 12 month period.