Management of Cervical Intra Epithelial Neoplasia by Loop Electrosurgical Excision Procedure in a Low Resource Country: An Experience from the Yaoundé General Hospital, Cameroon

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DOI: 10.4236/ojog.2015.59070    3,488 Downloads   4,609 Views  Citations

ABSTRACT

Background: Cervical cancer is the third most common cancer worldwide, and 80% of cases occur in the developing world. A critical component of effective cervical cancer screening programs is the ability to offer women appropriate and effective treatment for cervical intra epithelial neoplasia (CIN). Objectives: This study aimed at assessing the primary experience of management of CIN by Loop Electrosurgical Excision Procedure (LEEP) in a low resource country. Methods: We carried out a descriptive cross sectional study at the Yaoundé General Hospital in Cameroon. Results: Twenty three cases of CIN were treated by LEEP. Mean age of patients was 40.5 ± 9.9 years. Six (26.1%) patients were infected by the Human Immunodeficiency Virus (HIV). LEEP was indicated in 21 (91.30%) cases for CIN2 and CIN3. The mean duration of the surgical procedure was 10 ± 3 minutes. There was one (4.3%) complication (persistent cervical bleeding). Surgical margins were negative for dysplasia or invasive carcinoma in 18 (78.26%) cases and non-applicable in 5 (21.73%) cases (thermal artefacts of margins and cervicitis without CIN). One patient with micro invasive carcinoma on post-operative histology was treated by total hysterectomy. Cervical cytology was normal at 6 months post LEEP for 15 cases out of 16 (93.8%) patients who performed the test. One woman achieved pregnancy and delivered a term baby. Conclusion: Treatment of CIN by LEEP is feasible, safe and effective in our setting.

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Ngowa, J. , Ngassam, A. , Tsuala, J. , Metogo, J. , Sando, Z. , Kabeyene, A. and Kasia, J. (2015) Management of Cervical Intra Epithelial Neoplasia by Loop Electrosurgical Excision Procedure in a Low Resource Country: An Experience from the Yaoundé General Hospital, Cameroon. Open Journal of Obstetrics and Gynecology, 5, 481-486. doi: 10.4236/ojog.2015.59070.

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