A comparison between loop electrosurgical excision procedure and cold knife conization for treatment of cervical dysplasia: residual disease in a subsequent hysterectomy specimen.

OBJECTIVE

The purpose of this study was to determine whether the loop electrosurgical excision procedure (LEEP) is as effective as cold knife conization (CKC) in the removal of cervical dysplasia.

METHODS

One-hundred sixteen patients with cervical intraepithelial neoplasia were included: 73 cases treated with LEEP and 43 cases treated with CKC. All of these patients underwent subsequent hysterectomy within 6 months of treatment. A thorough histological evaluation of the cone specimens and post-cone hysterectomy specimens was performed.

RESULTS

No residual disease in the post-cone hysterectomy specimens was identified in 63% of the LEEP group and 72.1% of the CKC group. There was no significant difference in the proportion of negative residual disease (P > 0.05). The mean diameters of the base as well as the depth of the cone specimens were smaller in the LEEP group than in the CKC group (P < 0.05). The operating time in the LEEP group was significantly shorter than that of the CKC group (P < 0.05). Although thermal artifacts of margin were found in 8.2% of LEEP specimens, there was no difficulty in histological interpretation. Furthermore, the postoperative complications were similar in both groups.

CONCLUSION

The findings of this study demonstrate that the LEEP is a convenient, safe, and effective treatment for the management of cervical dysplasia. Cone specimens obtained during LEEP are adequate for thorough histological evaluation of cervical dysplasia.