The loop electrosurgical excision procedure (LEEP) is currently one of the most commonly used approaches to treat high grade cervical dysplasia (CIN II/III, HGSIL) discovered on colposcopic examination. It is also known as "large loop excision of the transformation zone" (LLETZ).[1] The procedure has many advantages including low cost, high success rate, and ease of use. The procedure can be done in an office setting and usually only requires a local anesthetic, though sometimes a general anesthetic is used.[2]
Process
When performing a LEEP, the physician uses a wire loop through which an electrical current is passed at variable power settings. Various shapes and sizes of loop can be used depending on the size and orientation of the lesion. The cervical transformation zone and lesion are excised to an adequate depth, which in most cases is at least 8 mm, and extending 4 to 5 mm beyond the lesion. A second pass with a more narrow loop can also be done to obtain an endocervical specimen for further histologic evaluation.[3]
The LEEP technique results in some thermal artifact in all specimens obtained due to the use of electricity which simultaneously cuts and cauterizes the lesion, but this does not generally interfere with pathological interpretation.
Complications
Complications are less frequent in comparison to a cold knife conization, but can include infection and hemorrhage. Damage to the cervical stroma may lead to cervical stenosis or incompetence. The LEEP does not appear to affect fertility.[4] However, a recent study indicated that LEEP appears to increase the risk of premature rupture of the membranes during subsequent pregnancies which may lead to preterm delivery.[5]
References
- ^ "Loop electrosurgical excision procedure (LEEP) for abnormal cervical cell changes". Retrieved 2007-12-28.
- ^ Mayeaux, Jr., E.J. "Advantages of LEEP". Retrieved 2007-12-28.
- ^ "LEEP Procedure - What is LEEP? - Loop Electrosurgical Excision Procedure". Cornforth. About.com. Tracee. Retrieved 2007-12-28.
{{cite web}}: Check date values in:|date=(help); Cite has empty unknown parameter:|coauthors=(help) - ^ Turlington, WT (November , 1996). "Impact of the loop electrosurgical excision procedure on future fertility". Department of Obstetrics and Gynecology, University of North Carolina, School of Medicine, Wilmington, USA. Retrieved 2007-12-28.
{{cite web}}: Check date values in:|date=(help); Unknown parameter|coauthors=ignored (|author=suggested) (help) - ^ Davis, Jeanie L. "Cervix Treatment May Endanger Pregnancy Later 'Watch and Wait' or Laser Are Often Best Options for Cervical Dysplasia". Retrieved 2007-12-28.
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