The influence of time intervals between loop electrosurgical excision and subsequent hysterectomy on the morbidity of patients with cervical neoplasia

Abstract

OBJECTIVE: To improve clinical prospects by reducing intraoperative or postoperative complications, subsequent hysterectomy is generally conducted within 48 h or 6 weeks after cervical cold-knife conization. The loop electrosurgical excision procedure (LEEP) is widely used for cervical conization. However, no study has ever been undertaken on the relation between postoperative sequelae and the time between LEEP and hysterectomy. Therefore, this study was undertaken to evaluate the correlations between postoperative sequelae and the interval between LEEP and hysterectomy. METHODS: The medical records of 338 patients, who underwent type 1 extended hysterectomy after LEEP at the Department of Obstetrics and Gynecology, Yonsei University College of Medicine, were retrospectively reviewed. The subjects were divided into three groups according to time from LEEP to hysterectomy: group 1 (within 48 h, n = 210), group 2 (between 48 h and 6 weeks, n = 88), and group 3 (>6 weeks, n = 40). RESULTS: The three groups showed no significant differences with respect to patient characteristics (age, delivery history, body mass index, and a history of surgery). Postoperative complications such as fever, dysuria, and surgical region complications (effraction, infection, and rubefaction) were not significantly different among the three groups. Other complications, namely, ureter injury and abdominal wall hematoma, were found in one case in each group 1. CONCLUSION: The postoperative clinical courses were not significantly different regardless of time interval between LEEP and subsequent hysterectomy. Therefore, hysterectomies can be conducted at any time when the patient is in an appropriate condition, i.e., not precisely within 48 h or >6 weeks after LEEP.