[LEEP versus cold knife conization for treatment of cervical intraepithelial neoplasias].
OBJECTIVE
This study was performed to evaluate the effectiveness and side effects of loop electrosurgical excision procedure (LEEP) in comparison to cold knife conization for the treatment of cervical intraepithelial neoplasia (CIN).


METHODS
Between January 1996 and July 1998, 177 patients underwent conization. In a matched-pair setting, 50 cases with LEEP were compared with 100 classical conization cases. LEEP was performed with ectocervical and endocervical excision.


RESULTS
Perioperative complications were less in the LEEP group (6% vs. 11%). The mean volume of LEEP specimens (1.6 cm3) was significantly smaller than the volume of cone specimens (2.6 cm3). Thermal artifacts were negligible. There were no significant differences in the proportion of margin involvement (20% vs. 19%) and residual/recurrent CIN. The endocervical excision contained dysplastic tissue in 38% of the cases; more important, a positive endocervical excision was found in 14/21 CIN 3 cases (67%). The success rate, was similar in both groups (96% vs. 97%). Hospitalization time was less for the LEEP group.


CONCLUSIONS
LEEP conization is a safe and cost effective procedure with a lower complication rate providing a significantly smaller specimen compared to cold knife conization. Therefore, LEEP conization may substitute cold knife conization. However, we do recommend to perform LEEP conization with an endocervical excision to reduce residual CIN.
Hillemanns
P
P
Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum Grosshadern. peter.hillemanns@t-online.de
Kimmig
R
R
Dannecker
C
C
Noorzai
T
T
Diebold
J
J
Thaler
C J
CJ
Hepp
H
H
D000328:Adult; D019092:Conization / Q000009:adverse effects / Q000379:methods*; D004598:Electrosurgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection; D016896:Treatment Outcome; D002577:Uterine Cervical Diseases / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000601:surgery*