Efficacy of contour-loop excision (C-LETZ) and conization of the cervix in high-grade squamous cervical intraepithelial lesions (HSIL)

Currently, despite the large number of excisional methods for treating HSIL, the frequency of residual lesions and relapses remains quite high and amounts to 30% - 50%, regardless of the chosen method. Purpose of the study. To evaluate the effectiveness of contour-loop excision (C-LETZ) and classical conization of the cervix in HSIL. Material and methods. Based on the State Healthcare Institution of the Moscow Region "MONIOG named after V.I. Krasnopolsky" from 2021 to 2023. 66 patients with histologically confirmed diagnosis of HSIL were treated, who underwent excisional treatment in the amount of classical conization of the cervix (n=32) – 1 group and loop-loop excision of the cervix using a wave-shaped cone C-LETZ (n=34) – 2 group. Results. During conization, damage to the endocervical crypts was more often noted at the apex of the removed cone (p=0.03), as well as the presence of HSIL in scraping from the cervical canal (p=0.01). In group 1, in 8% of women, the prevalence of intraepithelial lesion was limited to endocervical scraping in the absence of damage in the resected areas, and in group 2 - 0%. Residual lesions in group 1 within the period of up to 1 year of observation amounted to 6% (2/32), from 1 year to 2 years - in 12% (4/32). Relapse of the disease after 2 years of observation was diagnosed in 18% of women (6/32). Relapse of the disease after 2 years of observation was diagnosed 3 times less compared to group 1 - in 6% of women (2/34) (p=0.01). Conclusion. C-LETZ helps to reduce the presence of a positive endocervical edge and the persistence of HPV infection by 2 times, and residual lesions in the crypts of the endocervix by 1.5 times compared to classical conization.