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      Quality of tissue from punch biopsy forceps vs. round loop electrode in colposcopically directed biopsy: a randomized controlled trial

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          Abstract

          Objective

          To compare the quality of tissue from punch biopsy forceps (PB group) with round loop electrode (LE group) in colposcopically directed biopsy along with the evaluation of pain associated with each procedure.

          Methods

          Patients with abnormal cervical cytologic results and abnormal colposcopic findings were enrolled into a randomized trial into either a PB group or LE group. The quality of tissue was evaluated in regards to the size of tissue, site of tissue, and tissue damage. Each quality had 1 to 3 points and the sum of each quality contributed to the total tissue score that ranged from 3 to 9. Pain associated with each procedure was assessed by a visual analog scale (VAS). This was a clinical trial study and was registered at www.clinicaltrials.in.th (Identifier: TCTR20160404001).

          Results

          Ninety-six women who met all eligibility requirements were enrolled in the study. Forty-eight patients were randomly assigned to the PB group and 48 patients were randomized into the LE group. The characteristics of the patients were similar between the 2 groups with the exception of the median age. The median total tissue score was 8 points in the LE group which was more than the median of 7 points in the PB group with a statistically significant difference (p=0.014). However, the median VAS pain score in both groups was 3.4 (p=0.82).

          Conclusion

          The quality of cervical tissues obtained from biopsy with a round loop electrode was better than the punch biopsy forceps with no difference in the level of pain.

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          Most cited references10

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          Assessment of cervical intraepithelial neoplasia (CIN) with colposcopic biopsy and efficacy of loop electrosurgical excision procedure (LEEP).

          Conization for suspected high grade cervical intraepithelial neoplasia (CIN) is often performed based on abnormal cytology only. Loop electrosurgical excision procedure (LEEP) is a very common technique in this context. The present study analyses the accuracy of preoperative assessment of CIN with cytology plus colposcopic biopsy and assesses the efficacy of LEEP for the treatment of CIN.
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            European guidelines for quality assurance in cervical histopathology.

            The current paper presents Chapter 5 of the second edition of the European Guidelines for Quality Assurance in Cervical Cancer Screening, which deals with the histopathological diagnosis of lesions of the uterine cervix. It completes a series of publications in journals containing the contents of other parts of the European Guidelines. Histopathology provides the final diagnosis on the basis of which treatment is planned, and serves as the gold standard for quality control of cytology and colposcopy. It is also the source of the diagnostic data stored at the cancer registry and used for evaluation of screening programmes. It is therefore important that histopathology standards are monitored and based on agreed diagnostic criteria. Histology is required to diagnose the degree of abnormality in women with persistent low-grade abnormalities including HPV-lesions, as well as high-grade lesions. Cytology may also suggest either glandular abnormalities or be suggestive of high-grade CIN, AIS or invasive cancer. Histopathologists should be aware of, and familiar with, the nature of cytological changes which may be relevant to their reports. The accuracy of the histopathological diagnosis of tissue specimens depends on adequate samples, obtained by colposcopically directed punch biopsies (with endocervical curettage if necessary) or excision of the transformation zone or conisation. An accurate histological diagnosis further depends on appropriate macroscopic description, technical processing, microscopic interpretation and quality management correlating cytological and histological diagnosis. This paper proposes guidelines for sampling and processing of cervical tissue specimens obtained by biopsy, excision and/or curettage.
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              Analgesia for colposcopy: double-masked, randomized comparison of ibuprofen and benzocaine gel.

              To evaluate pain relief effectiveness of oral ibuprofen and topical benzocaine gel during colposcopy.
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                Author and article information

                Journal
                J Gynecol Oncol
                J Gynecol Oncol
                JGO
                Journal of Gynecologic Oncology
                Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology
                2005-0380
                2005-0399
                July 2018
                12 March 2018
                : 29
                : 4
                : e52
                Affiliations
                [1 ]Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
                [2 ]Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
                Author notes
                Correspondence to Athithan Rattanaburi. Division of Gynecologic Oncology, Department Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanit Soi 7 Rd, Tambon Kho Hong, Amphoe Hat Yai, Chang Wat Songkhla 90110, Thailand. r_athithan123@ 123456hotmail.com
                Author information
                https://orcid.org/0000-0002-2008-9829
                https://orcid.org/0000-0002-9423-5569
                https://orcid.org/0000-0003-0591-0751
                Article
                10.3802/jgo.2018.29.e52
                5981104
                29770623
                5a18b6c3-8f47-44f7-bd4d-d7a43a006257
                Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 September 2017
                : 01 November 2017
                : 03 March 2018
                Funding
                Funded by: Faculty of Medicine, Prince of Songkla University;
                Categories
                Original Article
                Cervix

                Oncology & Radiotherapy
                colposcopy,cervix uteri,biopsy,diagnostic equipment,histology,pain
                Oncology & Radiotherapy
                colposcopy, cervix uteri, biopsy, diagnostic equipment, histology, pain

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