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Double-LEEP Cone Procedure as an Alternative to Cold-Knife Conization in Management of Cervical Intraepithelial
1Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH.
Objectives:
To compare the double-LEEP cone procedure with cold-knife conization to treat cervical intraepithelial neoplasia; to evaluate the specimen adequacy regarding resection margins and residual disease.
Methods And Materials:
Of 137 patients with cervical intraepithelial neoplasia, 60 patients had cold-knife cone and 77 had double-LEEP cone procedure. The indications were the same for both groups. The average follow-up time was 6 months.
Results:
Therapeutic failure (incomplete excision) rate was 14% for double-LEEP cone procedure and 13% for cold-knife conization (p = 0.87). Recurrent cervical intraepithelial neoplasia rate was 16% for double-LEEP cone procedure and 7% for cold-knife conization (p = 0.44) at 6 months. Rates of bleeding complication were 2.6% for double-LEEP cone procedure and 3.3% for cold-knife conization (p = 0.80). These figures were not statistically significant. Thermal artifact was 10% of double-LEEP cone procedure specimens with only one with severe thermal damage preventing accurate grading of cervical intraepithelial neoplasia.
Conclusion:
There was no significant difference between double-LEEP cone procedure (86%) and cold-knife conization (87%) (p = 0.8). It appears that double LEEP performed as an outpatient procedure can be an acceptable alternative to cold-knife conization in patients with cervical intraepithelial neoplasia.▪.
