The efficacy of loop electrosurgical excision procedure as compared to cold-knife cone biopsy in patients with unsatisfactory colposcopy.

Abstract

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.