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The purpose of this trial is to determine whether SWETZ (Straight Wire Excision of Transformation Zone) is a superior alternative to LLETZ cone biopsy in the management of pre-invasive endocervical disease.
SWETZ is a new cone biopsy procedure performed with a straight wire electrode and it will be compared to LLETZ cone, which is performed with a large loop electrode.
The treatment of precancerous lesions hinges on the destruction, or more commonly, the excision of the cervical transformation zone (TZ). When the TZ contains squamous precancer and is completely ectocervical and therefore full visible, excision or destruction is an effective and relatively straightforward therapeutic entity. However in a small proportion of women a cone biopsy is necessary. A cone biopsy often requires the excision of 20-30 mms of endocervical canal.
1. The standard procedure, LLETZ - cone ( also called LEEP), is performed with a large loop electrode of 20-25 mm depth. The activated loop is applied to the cervix outside the lateral margin of TZ and brought slowly to the controlateral TZ margin with the objective to acquire 20-25 mm up the canal.
2. The experimental intervention is SWETZ, a method of excision using a 1cm straight disposal of 0.20 wire to remove the endocervical transformation zone or glandular disease. The activated wire is used as a knife, fashioning a cone with desired dimensions.
This technique may be able to excise the endocervical TZ with a lower rate of morbidity and incomplete excision rate than LLETZ cone biopsy.
The hypothesis to be tested in this trial is that SWETZ is superior to LLETZ cone biopsy in the management of endocervical pre-invasive disease.
Allocation: Randomized, Control: Active Control, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
Uterine Cervical Dysplasia
Straight Wire Excision of Transformation Zone, Large Loop Excision of Transformation Zone (cone biopsy)
Instituto Fernandes Figueira - Oswaldo Cruz Foundation
Rio de Janeiro
Oswaldo Cruz Foundation
Published on BioPortfolio: 2014-07-23T21:12:28-0400
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The excision of the head of the pancreas and the encircling loop of the duodenum to which it is connected.
Surgical excision of one or more lymph nodes. Its most common use is in cancer surgery. (From Dorland, 28th ed, p966)
Excision of the uterus.
The reconstruction of a continuous two-stranded DNA molecule without mismatch from a molecule which contained damaged regions. The major repair mechanisms are excision repair, in which defective regions in one strand are excised and resynthesized using the complementary base pairing information in the intact strand; photoreactivation repair, in which the lethal and mutagenic effects of ultraviolet light are eliminated; and post-replication repair, in which the primary lesions are not repaired, but the gaps in one daughter duplex are filled in by incorporation of portions of the other (undamaged) daughter duplex. Excision repair and post-replication repair are sometimes referred to as "dark repair" because they do not require light.
Used for excision of the urinary bladder.
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