LEEP excision of high grade cervical intraepithelial lesion to achieve appropriate excision margins

Background: In the case of cervical intraepithelial neoplasia (CIN), cervical conization is the treatment of choice. If resection is only partial, the remaining disease remains a risk. Yet, so far, there have been very few studies looking at how to optimize LEEP resection by removing more of the lesion. Aims and objectives: The goal of loop electrosurgical excision techniques (LEEP) for high-grade cervical intraepithelial lesions is to remove as much of the tumor as possible without leaving any healthy tissue behind. Subjects and methods: The Department of Obstetrics and Gynecology of Al Zahraa University Hospital, Al-Azhar University, Cairo, Egypt, participated in this cross-sectional, analytical study. Our study took part in and lasted for two and half years. 60 women with high-grade cervical intraepithelial lesions diagnosed with Pap smear undergone LEEP conization. 6 subjects were excluded due to having benign lesions on their LEEP biopsies. So, 54 subjects continued to be analyzed. All patients were subjected to the following: history taking, general examination, and local examination. Results: 68.5% of subjects had negative biopsy margins, while 31.5% had positive margins, with a statistically significant association with obesity, high-grade lesions, and carcinoma. Conclusion: It was concluded that the 7 mm cone depth for treating high-grade cervical intraepithelial lesions was appropriate for a higher negative cone margin after LEEP biopsy. Ki67 staining is beneficial in confirming the histopathological diagnosis.