RCOG World Congress 2025

Audit of LLETZ procedures at Calderdale and Huddersfield NHS Foundation Trust (CHFT)

To evaluate particular elements of the CHFT colposcopy service against national standards¹:

1.When LLETZ is required:

•% women having LLETZ procedure under general anaesthesia (GA) at CHFT- national recommendation <15% of women

•% women with a documented indication for treating under GA- national recommendation 100% of cases

2. When repeat LLETZ is indicated:

•% women aged 50+ offered repeat excision- national recommendation 100%

•% women with CGIN offered repeat excision- national recommendation 100%

Method

Retrospective audit from 1/1/23-31/12/23, including all patients attending colposcopy within CHFT (Halifax and Huddersfield Hospitals). Notes, histology investigations and MDT outcomes reviewed.

Results Summary 2023

347 LLETZ procedures undertaken

Overall repeat excision rate 6.75%

ü5% (18/347) were performed under GA

ü100% (347/347) had a documented reason for GA

ü100% (7/7) women aged 50 and above offered repeat excision for deep lateral and endocervical margin involvement

ü100% (9/9) women were offered repeat excision for incompletely excised CGIN

Complication rate 1.4% (5/347) due to bleeding or infection- only one patient admitted for IV antibiotics

Loss to follow-up 0%

Documentation was thorough and complete in 344/347 cases

Conclusion

The colposcopy service at CHFT is meeting national standards, with low overall repeat excision rates and complication rates. Commitment to high quality holistic patient care was evidenced throughout the patient’s journey from initial referral to completion of treatment and follow-up.

Reference: GOV.UK (2025) Guidance 4. Colposcopic diagnosis, treatment and follow up. Available at: https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/3-colposcopic-diagnosis-treatment-and-follow-up#CIN (Accessed: 29 May 2025).

RCOG World Congress 2025

Audit of LLETZ procedures at Calderdale and Huddersfield NHS Foundation Trust (CHFT)

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