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 elec trosurgical excision procedure (LEEP) is as effective as cold knife conizat ion (CKC) in the removal of cervical dysplasia. Methods. One-hundred sixteen patients with cervical intraepithelial neoplas ia 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 po st-cone hysterectomy specimens was performed, Results. No residual disease in the post-cone hysterectomy specimens was id entified 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 spec imens were smaller in the LEEP group than in the CRC 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 interpretati on. Furthermore, the postoperative complications were similar in both group s. Conclusion. The findings of this study demonstrate that the LEEP is a conve nient, safe, and effective treatment for the management of cervical dysplas ia, Cone specimens obtained during LEEP are adequate for thorough histologi cal evaluation of cervical dysplasia. (C) 1999 Academic Press.