*Gynecologic Oncology Program, Departments of Obstetrics and Gynecology ‡Pathology and Laboratory Medicine, University of Ottawa §Ottawa Hospital (General Campus), Ottawa, Ontario, Canada.
J Low Genit Tract Dis. 1999 Apr;3(2):116-20. doi: 10.1046/j.1526-0976.1999.08096.x.
Our aim was to determine whether the loop electrosurgical excision procedure (LEEP) is as efficacious as cone biopsy in patients with cervical dysplasia and unsatisfactory colposcopy.
Fifty-four patients with unsatisfactory coiposcopic findings underwent a LEEP procedure for the treatment of their cervical dysplasia. These patients were compared to 41 patients who had a cold-knife cone biopsy for the same indication. LEEP procedures were carried out to a standard ectocervical excision depth of 6 mm and then excised centrally to an endocervical depth of an additional 3 mm. An endocervical curettage was performed after the excision procedure. Patients were examined every 4 to 6 months after treatment with a Papanicolaou smear and colposcopy. The pretreatment cytology and cervical biopsies, histology of LEEP and cone biopsy specimens, and follow-up cytology between the two groups were compared by chisquare analysis.
No statistical difference was seen in the pretreatment cervical smears between the LEEP and cone biopsy groups. All LEEP and cone biopsy specimen resection margins were negative. No difference was evident in the grade of cervical intraepithelial neoplasia between the LEEP and cone biopsy groups. Follow-up cervical smear results were similar in both groups. One patient required a cone biopsy for persistent disease 8 months after her LEEP treatment.
LEEP appears to be as safe and effective as cone biopsy in patients with unsatisfactory colposcopy.
我们旨在确定环形电切术（LEEP）对于阴道镜检查不满意的宫颈上皮内瘤变患者的疗效是否与锥形切除术相当。
54 例阴道镜检查不满意的患者接受了 LEEP 手术治疗宫颈上皮内瘤变。将这些患者与 41 例因相同指征行冷刀锥形切除术的患者进行比较。LEEP 手术的标准是切除 6mm 的外宫颈，然后再向宫颈内切除 3mm。切除后进行宫颈管搔刮术。治疗后，患者每 4 至 6 个月接受巴氏涂片和阴道镜检查。通过卡方分析比较两组患者的预处理细胞学和宫颈活检、LEEP 和锥形活检标本的组织学以及随访细胞学。
LEEP 和锥形切除术组的预处理宫颈涂片无统计学差异。所有 LEEP 和锥形切除术的标本切缘均为阴性。LEEP 和锥形切除术组的宫颈上皮内瘤变程度无明显差异。两组的随访宫颈涂片结果相似。1 例患者在 LEEP 治疗 8 个月后因持续病变需要行锥形切除术。
LEEP 对于阴道镜检查不满意的患者似乎与锥形切除术一样安全有效。
