Simmons J R, Anderson L, Hernandez E, Heller P B
Department of Obstetrics and Gynecology, Medical College of Pennsylvania-Hahnemann School of Medicine, Allegheny University of the Health Sciences, Philadelphia, USA.
J Reprod Med. 1998 Dec;43(12):1007-13.
To determine how the loop electrosurgical excision procedure (LEEP) compares to cold knife conization in providing an adequate diagnostic specimen.
Between 1991 and 1995, 95 patients underwent either diagnostic LEEP or cold knife conization at Allegheny University Hospitals. The indications for the procedure were a cytologic/histologic discrepancy, unsatisfactory colposcopic evaluation, positive endocervical curettage or exclusion of invasion.
Severe thermal artifact rendered the LEEP specimens uninterpretable in 4.4% of cases. A median number of two passes were required for LEEP excision of the transformation zone. The number of passes correlated with the amount of thermal artifact detected (P = .034). Regarding recurrence patterns, normal follow-up cervical cytology was similar for both groups: 96.7% in the LEEP group vs. 100% in the cold knife conization group.
We conclude that LEEP is an acceptable diagnostic alternative to traditional cold knife conization. Thermal artifact remains a disadvantage that can be minimized by limiting the number of passes required to obtain a complete specimen.
确定环形电切术（LEEP）与冷刀锥切术在获取足够诊断标本方面的比较情况。
1991年至1995年间，95例患者在阿勒格尼大学医院接受了诊断性LEEP或冷刀锥切术。手术指征为细胞学/组织学不符、阴道镜评估不满意、宫颈管刮术阳性或排除浸润。
4.4%的病例中，严重的热损伤使得LEEP标本无法解读。转化区的LEEP切除平均需要两次切割。切割次数与检测到的热损伤量相关（P = .034）。关于复发模式，两组的正常随访宫颈细胞学检查相似：LEEP组为96.7%，冷刀锥切术组为100%。
我们得出结论，LEEP是传统冷刀锥切术可接受的诊断替代方法。热损伤仍然是一个缺点，可以通过限制获取完整标本所需的切割次数来将其降至最低。
