ELECTZElectrosurgical Loop Excision of the Cervical Transformation Zone (excisional procedure)
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The "see and treat" ELECTZ procedure has been practiced by many physicians, particularly by clinicians from Europe.[1,4-6] The early commercial marketing strategy for electrosurgical loop excision procedures in the United States emphasized the advantages of "see and treat" patient management.
Inclusion criteria were minimum age of 16 years, an abnormal Pap smear result, colposcopic evidence of cervical dysplasia, and voluntary agreement to undergo "see and treat" ELECTZ following informed consent.
Subjects with abnormal cervical Pap smears, colposcopic evidence of cervical intraepithelial neoplasia (CIN), or an unsatisfactory colposcopic examination were treated by simple ELECTZ or ELECTZ conization ("cowboy hat").
Forty-eight women were enrolled in the study and had "see and treat" ELECTZ. The average age of the subjects was 31.8 years and the range was 16 to 63 years.
Fifteen simple ELECTZ and 33 ELECTZ conization procedures were performed.
Preliminary Cervical Cytologic Findings Compared with Loop Excision Histologic Results for "See and Treat" Elcctrosurgical Loop Excision of the Cervical Transformation Zone (ELECTZ) (N=47)
Electrosurgical loop excision of the cervical transformation zone and ELECTZ conization may be safely and effectively performed in office settings by family physicians.
Electrosurgical loop excision of the cervical transformation zone (ELECTZ) is an excisional surgical procedure of premalignant cervical disease and the abnormal transformation zone by a relatively low-voltage, high-frequency alternating current wire loop electrode.
The potential benefits of the ELECTZ procedure should be balanced by its potential disadvantagcs.
Family physicians are acquiring colposcopy-related skills, and competency based on a colposcopic accuracy index has been demonstrated.[1] The common learning errors and preclinical psychomotor skills acquisition of physicians learning the ELECTZ procedure have also been described.[2] Prospective studies of the procedure, therapeutic outcomes, and compfications have been published in the gynecologic literature.[3-5] The technical and general principles of electrosurgery have been reviewed,[6] and the electrosurgical loop excision method described in the family medicine literature.[7,8] To date, however, there has been no prospective study of the ELECTZ or ELECTZ conization procedures performed by family physicians.
Inclusion criteria were a minimum age of 16 years, cytologic, colposcopic, or histologic evidcnce of cervical dysplasia, and informed consent to undergo the ELECTZ procedure.
Data were collected on all patients scheduled for ELECTZ procedures during the 2-year enrollment and follow-up study period at each of the five sites.