Lugol's Solution Reduces Positive Margins and Residual Disease After the Large Loop Excision of Transformation Zone

Min Jeong Kim, Grace J. Lee, Eun Ji Lee, Seungmee Lee, Doo Byung Chay, Chae Hyeong Lee, Jae Hoon Kim, Ju Won Roh

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This study aimed to examine whether the intraoperative use of Lugol's solution reduces the proportion of positive resection margins (RMs) using the data of women who underwent large loop excision of the transformation zone (LLETZ). Materials and Methods: A total of 1,751 consecutive women with cervical intraepithelial neoplasia (CIN) who underwent LLETZ with or without Lugol's solution were retrospectively retrieved from each database of 3 university hospitals in South Korea. Outcomes included positive RMs and residual disease pathologically confirmed within 6 months after LLETZ. Results: Positive RMs were noted in 345 cases (19.7%). Among 1,507 women followed up, residual disease was diagnosed in 100 cases (6.6%) (69/308 cases with positive RMs; 31/1,199 cases with negative RMs). The Lugol's solution group was less likely to have positive RMs (11.8% vs 25.5%, p <.01), to require additional surgical intervention (5.4% vs 10.2%, p <.01), and to have residual disease (4.9% vs 8.0%, p =.02). On multiple logistic regression analysis, Lugol's solution reduced the proportion of positive RMs (adjusted odds ratio [aOR], 0.31). Age (50 years or older; aOR, 1.64), preconization cervical cytology (aOR, 1.53), high-risk human papillomavirus (aOR, 1.75), and CIN 2 or 3 (aOR, 2.65) were independent risk factors for margin positivity (p <.01 for all except high-risk human papillomavirus of p =.05). Conclusions: Lugol's solution optimizes CIN treatment by reducing the proportion of positive RMs and residual disease after LLETZ.

Original languageEnglish
Pages (from-to)12-17
Number of pages6
JournalJournal of Lower Genital Tract Disease
Volume28
Issue number1
DOIs
StatePublished - 1 Jan 2024

Keywords

  • cervical intraepithelial neoplasm
  • conization
  • resection margins
  • residual tumors

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