{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:43:37Z","timestamp":1787013817951,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T00:00:00Z","timestamp":1580342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Large loop excision of the transformation zone (LLETZ) is the preferred treatment for cervical intraepithelial neoplasia due to its effectiveness and ability to be performed in an outpatient setting under local anaesthesia (LA). Although current guidelines recommend that most LLETZ can be performed under LA, there is paucity in clinical data of patients' perspectives of outpatient LLETZ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Determining patient acceptability of outpatient LLETZ through assessment of anxiety and pain scores, and comparing treatment outcomes with current standards in terms of margins status, negative histology, short\u2010term morbidity rates and follow\u2010up attendance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This study was conducted at a tertiary hospital over two years (2014\u20132016). Patients undergoing outpatient LLETZ completed a three\u2010part questionnaire (before, immediately after and 4\u20136\u00a0weeks post\u2010procedure).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and five patients underwent outpatient LLETZ. Mean pain score was 2 (range 0\u20138). Pre\u2010procedure anxiety was common but most resolved post\u2010procedure. Women who did not have a prior LLETZ discussion were more likely to report moderate\u2010severe anxiety levels pre\u2010procedure, compared with women who did (odds ratio 3.00, 95% CI 1.11\u20138.09,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.030). There were no differences found in pain scores when comparing pre\u2010procedure anxiety levels, prior discussion of LLETZ or mode of anaesthesia. Specimen margins were involved in 42.9%. No association was found between positive cervical margin status and age, pre\u2010procedure anxiety or post\u2010procedure pain scores. Most patients were satisfied and attended follow\u2010up appointments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Large loop excision of the transformation zone under LA is a well\u2010tolerated procedure with high satisfaction and follow\u2010up rates. Clinicians need to initiate early discussions regarding treatment to minimise procedure\u2010related anxiety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajo.13121","type":"journal-article","created":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T22:06:48Z","timestamp":1580422008000},"page":"438-443","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["LLETZ make it simple: Anxiety, pain and treatment outcomes with outpatient large loop excision of the transformation zone under local anaesthesia"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6868-3739","authenticated-orcid":false,"given":"Shui\u2010Jean","family":"Yap","sequence":"first","affiliation":[{"name":"King Edward Memorial Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Nathan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Western Australia Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Farrell","sequence":"additional","affiliation":[{"name":"King Edward Memorial Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,30]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"National Cervical Screening Program: Guidelines for the Management of Screen\u2010Detected Abnormalities, Screening in Specific Populations and Investigation of Abnormal Vaginal Bleeding","author":"Cancer Council Australia Cervical Cancer Screening Guidelines Working Party","year":"2016"},{"key":"e_1_2_6_3_1","first-page":"CD001318","article-title":"Surgery for cervical intraepithelial neoplasia","author":"Martin\u2010Hirsch PP","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-199509000-00022"},{"key":"e_1_2_6_5_1","first-page":"CD006120","article-title":"Pain relief for women with cervical intraepithelial neoplasia undergoing colposcopy treatment","volume":"7","author":"Gajjar K","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2013.08.008"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1996.tb02725.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2012.01420.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01664.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2013.07.001"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2012.01.025"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1074-3804(96)80013-2"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00064.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004040050202"},{"key":"e_1_2_6_15_1","first-page":"55","volume-title":"Colposcopy and Programme Management","author":"NHS - National Health Service","year":"2016"},{"key":"e_1_2_6_16_1","volume-title":"National Cervical Screening Programme Policies and Standards: Section 6 \u2013 Providing a Colposcopy Service","author":"Ministry of Health","year":"2013"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610902993368"},{"key":"e_1_2_6_18_1","first-page":"76","article-title":"Complications of outpatient LLETZ procedures","volume":"49","author":"Dunn TS","year":"2004","journal-title":"J Reprod Med"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2005.06.007"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30700-3"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-200008000-00025"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fajo.13121","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13121","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.13121","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T22:31:16Z","timestamp":1693953076000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,30]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1111\/ajo.13121"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13121","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,30]]},"assertion":[{"value":"2019-02-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}