Short-Term and Long-Term Results of Loop Excision (LLETZ) and Cervical Conization in the Treatment of High-Grade Squamous Intraepithelial Lesions

Aim. To evaluate the results of Large Loop Excision of the Transformation Zone (LLETZ) and conization in the treatment of high-grade squamous intraepithelial lesions of the cervix. Design. Retro-, prospective study. Materials and methods. The study included 100 patients of reproductive age with high-grade squamous intraepithelial lesions (HSIL). Of these, 50 patients underwent conization of the cervix (Group I) and 50 patients underwent loop excision of the cervix LLETZ (Group II). The study included a clinical examination of patients, anamnestic analysis, control of cytological examination of smears, testing for human papillomavirus (HPV) with genotyping (15 types), extended colpospopia at the 3rd, 6th, 12th and 24th months after excisional treatment. Results. After conization of the cervix, persistence of HPV infection for a year was recorded in 10 (20%) women, residual lesions — in 9 (18%), relapse of the disease within 2 years was also detected in 9 (18%) patients. Of 50 women who underwent cervical excision, persistent HPV infection was observed in 8 (16%), residual lesions — in 11 (22%), and disease recurrence — in 10 (20%). When the disease relapsed, repeated excisional interventions were used. Conclusion. Currently, there are many excision treatments for HSIL, but none of the options completely eliminate recurrences. When choosing a technology for removing pathological tissue of the cervix, optimization and a personalized approach are required. Keywords: excision, conization, cervix, Large Loop Excision of the Transformation Zone, squamous intraepithelial lesions.