Loop excision for cervical intraepithelial neoplasia.
We report the results of a prospective trial using a loop electrosurgical excision procedure (LEEP) on 97 patients with cervical intraepithelial neoplasia. In the LEEP group the mean cutting time and whole procedure time were 6.2 +/- 1.9 seconds and 12.7 +/- 3.5 minutes, respectively. The average blood loss was 3.6 +/- 1.9 mL. In the control group (39 cases) using laser conization, the mean cutting time and whole procedure time were 11.7 +/- 3.5 minutes and 44.9 +/- 8.9 minutes, respectively. The average blood loss in the control group was 11.2 +/- 3.1 mL. The differences between the two groups were statistically significant. During LEEP surgery, four cases had accidental vaginal excision. There were three cases of late cervical bleeding after surgery; the surface of the cervix was smooth, and no adhesion or crypt formation was noted after re-epithelialization. Eight patients became pregnant after the loop excision and no cervical incompetence was noted during antenatal care. After a one-year follow-up period in the colposcopy clinic, there was no recurrence of cervical intraepithelial neoplasia in either group. We advise that among the modalities of treatment for cervical intraepithelial neoplasia, LEEP appears to offer patients several benefits such as less bleeding, precise specimens, local anesthesia, less cost and less discomfort. It is particularly suitable for treating younger women who have not yet completed their families.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
C J
CJ
Tseng
Y K
YK
Soong
C C
CC
Liang
S
S
Hsueh
D000328:Adult; D000368:Aged; D004598:Electrosurgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D002583:Uterine Cervical Neoplasms / Q000601:surgery*