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Re: Gyn: Positive margins on a LEEP From: Joanne Bulley, MD (islesannie@gmail.com) Fri Nov 2 15:10:54 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: Gyn: Positive margins on a LEEP" Previous message: Gordon Goldman: "Re: Gyn: Positive margins on a LEEP" In reply to: Gordon Goldman: "Re: Gyn: Positive margins on a LEEP" Next in thread: Garry E. Siegel, M.D.: "Re: Gyn: Positive margins on a LEEP" Reply: Garry E. Siegel, M.D.: "Re: Gyn: Positive margins on a LEEP" Reply: Henry Gregor: "Weekend post" Can you use an endocervical speculum to get an ECC that is higher than the disease? I have been surprised how many times if I hold the ectocervix open I can get upper endocervical tissue that is free of disease. If it is positive then there is the judgement call for whether you got some of the ectocervical disease in the specimen. Joanne At Fri, 2 Nov 2007, Gordon Goldman wrote: > >Variation on the theme: > >19 y/o single female with ASCUS-LGSIL/cannot exclude HGSIL +H/R HPV->- > > Colpo 12-06 CIN I & II (vault neg)----> LEEP CINI &CINII w/free >margins both endo and exocervix. Advised F/U pap q 3mos. Does not >return until 10-07 (not a reliable pt) and now has ASCUS-LGSIL/cannot >exclude HGSIL again. Uses condoms plus OCs and non-smoker and no >drugs. Local onc. says follow with serial colpos and as long as no >greater than CINII, just obs. My concern is if recurrence is high in >endocx and not amenable to colpo visualization, does neg ECC >necessarily mean no disease in face of otherwise neg colpo (or even >+colpo visualization). > >Gordon > >On Nov 2, 2007, at 1:21 PM, Henry Gregor wrote: > >> > At Thu, 1 Nov 2007, Larry Glazerman wrote: >> > > >> > >Joanne: >> > > >> > >Why not laparoscopic hysterectomy???? >> > > >> > >> >> Larry, >> Not trying to be persnickety, but I thought the original concern >> was delilneating a satisfactory circumference/margin on cervix and >> vagina. Wouldn't an LAVH give up some precision re placement of >> that resection line? >> >> Hank >> Tired of spam? Yahoo! Mail has the best spam protection around -- Joanne Bulley, MD, FACOG Solo gyn Keene, NH USA Next message: Garry E. Siegel, M.D.: "Re: Gyn: Positive margins on a LEEP" Previous message: Gordon Goldman: "Re: Gyn: Positive margins on a LEEP" In reply to: Gordon Goldman: "Re: Gyn: Positive margins on a LEEP" Next in thread: Garry E. Siegel, M.D.: "Re: Gyn: Positive margins on a LEEP" Reply: Garry E. Siegel, M.D.: "Re: Gyn: Positive margins on a LEEP" Reply: Henry Gregor: "Weekend post"

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