DEEP LOOP EXCISION FOR PREHYSTERECTOMY ENDOCERVICAL EVALUATION

OBJECTIVE: Our purpose was to determine whether office deep loop excis ion should replace cone biopsy for frozen-section endocervical evaluat ion before planned hysterectomy. STUDY DESIGN: This cohort study compr ised 31 patients who underwent office deep loop excision with frozen-s ection analysis followed by hysterectomy and 50 historic controls who underwent cone biopsy with frozen-section analysis followed by hystere ctomy. Diagnostic accuracy, margin status, presence of residual diseas e, morbidity, and cost were compared. RESULTS: Loop excision frozen se ctions had sensitivity (ectocervical specimen, 96%; deepest endocervic al specimen, 93%), specificity (100%, 86%), and positive (100%, 88%) a nd negative (75%, 92%) predictive values similar to those of frozen co ne biopsy (95%, 80%, 98%, and 67%, respectively). No differences in ma rgin status, presence of residual dysplasia, or morbidity were observe d. The shorter operating room time for vaginal hysterectomy after loop excision (p < 0.01) resulted in an approximate $2000 savings. CONCLUS ION: Office loop excision is a cost-effective option for endocervical evaluation before planned hysterectomy.