TITLE:
Management of Cervical Intra Epithelial Neoplasia by Loop Electrosurgical Excision Procedure in a Low Resource Country: An Experience from the Yaoundé General Hospital, Cameroon
AUTHORS:
Jean Dupont Kemfang Ngowa, Anny Ngassam, Jovanny Fouogue Tsuala, Juny Metogo, Zacharie Sando, Angèle Kabeyene, Jean Marie Kasia
KEYWORDS:
Cervical Cancer, Cervical Intraepithelial Neoplasia, LEEP, Screening Cervical Cancer, Low Resource Country
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.9,
August
25,
2015
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.