Efficacy of Electroresection with the Diathermy Loop for the Treatment of Cervical Intraepithelial Neoplasia

Introduction: Recent improvements in the understanding of the natural progression of cervical intraepithelial neoplasia (CIN) and in the knowledge of the treatments of pregnancy related morbidity, in addition to the progression of mean age of first pregnancy, brings out the need to rethink CIN management. There are currently two different modalities in the treatment of cervical dysplasia: local destruction and excision (loop diathermy, cold-knife conisation and laser conisation). The loop electrosurgical excision procedure (LEEP) is the most commonly used technique today for the practice of conisation, regardless of the lesion’s size or level of junction in the endocervix. The aim of our study was to analyse the efficiency of LEEP and the incidence of complications in the per- and post-operative period.
Material and method: We enrolled 49 hospitalized patients who underwent loop diathermy excision of the cervix, in a period spanning two years between January 2009 and December 2011 at the Hospital Saint Die in France.
Results: As far as grading is concerned, 2 patients were CIN 1 (4.54%), 18 were CIN 2 (40.9%) and 24 were CIN 3 (54.54%). In 41 cases (93.18%) the resection was done within safety margins – healthy tissue, in three cases (6.12%) the excision was incomplete. Five patients referred to hospital with postoperative bleeding.
Conclusions: In our experience LEEP could be considered the treatment of choice for cervical dysplasia when colposcopy is satisfactory, because it is effective, simple, fast, inexpensive, unaggressive, has a low morbidity and it permits adequate pathological examination.