[Evaluation of the recurrence and residual lesions incidence after loop electroexcisional procedure and cold knife...

The aim of this paper was the evaluation of the recurrence and residual lesions of cervical intraepithelial neoplaisa (CIN) incidence after LEEP (loop electro excisional procedure) and cold knife conisation. The clinical material was 210 women aged 22-65 years of life referred to the Department of Gynecology and Oncology Jagiellonian University Medical College in Krakow, Poland, the period in 2000- 2005 years, with initial cytological pap diagnosis-HSIL. (high grade squamous intraepithelial lesion-HSIL) according to The Bethesda System. The study group was 115 women with colposcopically visible lesions, which was qualified to the LEEP procedure. The controls were 95 women, preoperatively diagnosed based on colposcopically directed biopsy of the ectocervix and cervical canal curettage. In all cases the recurrence of cervical dysplasia and residual disease of cervical intraepithelial neoplasia incidence were analyzed. The follow-up period was 5 years with Pap smear and colposcopy every 3 months, for the first 2 years and every 6 months in subsequent 3 years. In case of recurrence which was diagnosed within first 6 months the residual disease was assumed rather than recurrence one. Data were statistically analyzed. We conclude that the therapeutical effect depends on CIN (cervical intraepithelial neoplasia) localization within cervix, because in case of cervical canal localization the recurrence and residual disease percentage is significantly higher in comparision to the ectocervix localization. This is why the colposcopic precise localization of the lesion within cervix is of the great importance. The free margins of the removed tissue speciemen are also the important prognostic factor. Most of the recurrence are diagnosed within the first year after initial procedure and does not depend on the margins involvement.