title: Comparison of Two Step LEEP and Cold Conisation For Cervical Intraepithelial Lesions to Decrease Positive Surgical Margins.
abstract: OBJECTIVE
  To assess the success rates of two step loop electrosurgical excision procedure (LEEP) compared with conventional cold conization procedures for decreasing positive surgical margins.
  
  
  METHODS
  This study was conducted on 70 patients who underwent colposcopic evaluation in Zeynep Kamil Women and Children's Health Training and Research Hospital between 20132015 with indications of CIN 2/3 or persistent CIN 1 for more than 2 years. The study included age matched groups of patients with similar histopathololical lesions who underwent cold conization (n=40) or LEEP (N=30).
  
  
  RESULTS
  Comparison of tissue characteristics between the two groups revealed significantly higher deepest depth and lower volume of tissue removed by the two step LEEP. Ectocervical positivity rate was similar between groups (1/39 versus 0/29, P>0.05), while endocervical surgical margin positivity rate was significantly higher in the cold conization group (9/39 versus 0/29, P<0.05). Surgical margin positive cases were significantly older than the cases with negative margins (P<0.05).
  
  
  CONCLUSIONS
  Two step LEEP made it easier to reach the squamocolumnar junction in the endocervical region with lower blood loss and applicability in office settings. Our study suggests to use two step approach in cases with high grade and glandular CIN.
authors: Zeynep Kamil Training and Research Hospital, Obstetric and Gynecology Department, Istanbul, Turkey Email : taylan_senol@hotmail.com.
authors: Taylan
authors: T
authors: Senol
authors: Mesut
authors: M
authors: Polat
authors: Enis
authors: E
authors: Ozkaya
authors: Ates
authors: A
authors: Karateke
mesh_terms: D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery; D019092:Conization / Q000379:methods*; D004598:Electrosurgery / Q000379:methods; D005260:Female; D006801:Humans; D000072662:Margins of Excision; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery