Loop electrical excision procedure: Difference between revisions

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The '''loop electrosurgical excision procedure''' ('''LEEP''') is one of the most commonly used approaches to treat high grade [[cervical dysplasia]] ([[Cervical intraepithelial neoplasia|CIN]] II/III, [[High grade squamous intraepithelial lesion|HGSIL]]) and early stage [[cervical cancer]] discovered on [[colposcopy|colposcopic]] examination. In the UK, it is known as '''large loop excision of the transformation zone''' ('''LLETZ'''). It is considered a type of [[Cervical conization|conization.]]<ref name="g323">{{Citecite journalweb |date last=2022-12-22Pflugner | first=Lindsey | title=Loop Electrosurgical Excision Procedure (LEEP): Pre-ProcedureBackground, TechniqueIndications, Post-Procedure | website=Medscape Reference | date=2024-03-21 | url=https://emedicine.medscape.com/article/1998067-overview?form | access-date=fpf2024-08-08}}</ref> It has been in use since the 1970s, after its invention by Dr. Sheldon Weinstein. <ref>{{Cite web |title=Loop Electrosurgical Excision Procedure (LEEP) {{!}} Embryo Project Encyclopedia |url=https://embryo.asu.edu/pages/loop-electrosurgical-excision-procedure-leep |access-date=2023-11-16 |website=embryo.asu.edu}}</ref>

LEEP has many advantages including low cost and a high success rate.<ref>{{cite web |url=http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes |title=Loop electrosurgical excision procedure (LEEP) for abnormal cervical cell changes |access-date=2016-11-27}}</ref> The procedure can be done in an office setting and usually only requires a [[local anesthetic]], though sometimes IV sedation or a [[general anesthetic]] is used.<ref>{{cite web |url=http://lib-sh.lsuhsc.edu/fammed/atlases/leep/leepadv.html |title=Advantages of LEEP |access-date=2007-12-28 |last=Mayeaux |first=E.J. Jr.|url-status=dead |archive-url=https://web.archive.org/web/20060904092302/http://lib-sh.lsuhsc.edu/fammed/atlases/leep/leepadv.html |archive-date=2006-09-04 }}</ref> Disadvantages include reports of decreased sexual satisfaction <ref name=":0">{{cite journal |last1=Inna |first1=Namfon |last2=Phianmongkhol |first2=Yupin |last3=Charoenkwan |first3=Kittipat |date=1 March 2010 |title=Sexual function after loop electrosurgical excision procedure for cervical dysplasia |journal=J Sex Med |volume=7 |issue=3 |pages=1291–1297 |doi=10.1111/j.1743-6109.2009.01633.x |pmid=19968775}}</ref> and potential for [[preterm labor]], though a meta-analysis published in 2014 suggested that in patients with existing CIN lesions as opposed to controls, the risk is not more than their baseline risk.<ref name="pmid24785601">{{cite journal |vauthors=Conner SN, Frey HA, Cahill AG, Macones GA, Colditz GA, Tuuli MG |date=April 2014 |title=Loop electrosurgical excision procedure and risk of preterm birth: a systematic review and meta-analysis |journal=Obstetrics and Gynecology |volume=123 |issue=4 |pages=752–61 |doi=10.1097/AOG.0000000000000174 |pmc=4113318 |pmid=24785601}}</ref> Approximately 500,000 LEEP procedures are performed in the U.S. annually. <ref>{{Cite journal |last1=Sklavos |first1=Martha M. |last2=Spracklen |first2=Cassandra N. |last3=Saftlas |first3=Audrey F. |last4=Pinto |first4=Ligia A. |date=2014 |title=Does Loop Electrosurgical Excision Procedure of the Uterine Cervix Affect Anti-Müllerian Hormone Levels? |journal=BioMed Research International |volume=2014 |pages=875438 |doi=10.1155/2014/875438 |issn=2314-6133 |pmc=3953513 |pmid=24707500 |doi-access=free }}</ref>