Loop electrosurgical excision procedure for cervical intraepithelial neoplasia - retrospective analysis

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  • MATSUZAKA Sunao
    Department of Obstetrics and Gynecology, Otsu Red Cross Hospital Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center
  • MORISHITA Hajime
    Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center
  • FUJITA Kohei
    Department of Obstetrics and Gynecology, Otsu Red Cross Hospital
  • HIROSE Masaya
    Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center

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  • ループ式電気焼灼切除術による子宮頸部円錐切除術に関する後方視的検討
  • ループシキ デンキ ショウシャク セツジョジュツ ニ ヨル シキュウ ケイブ エンスイ セツジョジュツ ニ カンスル コウホウ シテキ ケントウ

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Abstract

<p>The loop electrosurgical excision procedure (LEEP) is one of the treatments for cervical intraepithelial neoplasia. We performed a retrospective analysis of 299 patients who underwent a LEEP conization for cervical intraepithelial neoplasia(CIN)between 2011 and 2017 at our hospital. Following LEEP conization, 5 patients(1.7%) preoperatively diagnosed with CIN3 were upstaged and diagnosed with cervical cancer, stage IA1. Of all patients, 49 (16.4%) required an unscheduled examination because of post-operative genital bleeding. No patient suffered from cervical stenosis after LEEP conization. Of 290 diagnosed with CIN3, 12 (4.1%) patients required additional surgical treatment after the initial LEEP conization procedure. Nine patients showed disease involvement in endocervical and/or ectocervical margins, while 2 had disease-free margins. Forty subsequent pregnancies occurred in 36 (12.0%) patients. In those with delivery after 22 weeks of gestation, the rate for preterm birth was 10.0% (3/30). In the present cohort who underwent LEEP conization, preoperative diagnosis of CIN was accurate in nearly all cases and therapeutic efficacy was substantially demonstrated, though some showed residual or recurrent lesions. In addition, there were relatively few adverse effects related to the LEEP conization procedure on subsequent pregnancy. [Adv Obstet Gynecol, 72 (3) : 251-258, 2020 (R2.8)]</p>

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