Loop electrosurgical excision procedure for partial upper vaginectomy

• Published in: American journal of obstetrics and gynecology Vol. 181; no. 6; pp. 1382 - 1385
• Main Authors: Fanning, James, Manahan, Kelly J., McLean, Scott A.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.12.1999; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cervical Intraepithelial Neoplasia - diagnosis; Cervical Intraepithelial Neoplasia - surgery; Electrosurgery - methods; Female; Humans; LEEP; loop electrosurgical excision procedure; Medical sciences; Middle Aged; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Technology. Biomaterials. Equipments; Treatment Outcome; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - surgery; Vagina - surgery; Vaginal intraepithelial neoplasia; Vaginal Neoplasms - diagnosis; Vaginal Neoplasms - surgery; vaginectomy; vaginectomy; Vaginal intraepithelial neoplasia; loop electrosurgical excision procedure; LEEP; Human; Treatment efficiency; Vagina; Vaginal diseases; Electrosurgery; Malignant tumor; Female genital diseases; Exeresis; Surgery; Adult; Female; Technique; Elderly
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/S0002-9378(99)70379-0

Objectives: Partial upper vaginectomy consists of removal of the vaginal apex and is indicated for the diagnosis and treatment of vaginal intraepithelial neoplasia and recurrent cancer. We present a novel surgical approach to partial upper vaginectomy by use of the loop electrosurgical excision procedure. Study Design: A total of 15 consecutive patients with abnormal vaginal cytologic results were treated by the loop electrosurgical excision procedure for partial upper vaginectomy. After submucosal injection of local anesthetic, the loop electrode was used to resect the upper third of the vagina. An iodoform vaginal pack was placed for 24 hours. All patients with high-grade vaginal intraepithelial neoplasia received intravaginal 5-fluorouracil cream postoperatively. Results: The mean blood loss was 0 mL, and the mean surgical time was 30 minutes. A complication developed in 1 patient (7%). One case of invasive carcinoma was diagnosed. No recurrences have developed in any patients with vaginal intraepithelial neoplasia after hysterectomy. Conclusions: The loop electrosurgical excision procedure for partial upper vaginectomy can be performed quickly, with minimal blood loss, minimal complications, and minimal recurrence of neoplasia, and it provides a histologic specimen for evaluation. (Am J Obstet Gynecol 1999;181:1382-5.)