Evaluating cervical neoplasia: LEEP as an alternative to cold knife conization

Jeane Holmes, Lisa Anderson, Enrique Hernandez, Paul B. Heller

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


OBJECTIVE: To determine how the loop electrosurgical excision procedure (LEEP) compares to cold knife conization in providing an adequate diagnostic specimen. STUDY DESIGN: Between 1991 and 1995, 95 patients underwent either diagnostic LEEP or cold knife conization at Allegheny University Hospitals. The indications for the procedure were a cytologic/histologic discrepancy, unsatisfactory colposcopic evaluation, positive endocervical curettage or exclusion of invasion. RESULTS: Severe thermal artifact rendered the LEEP specimens uninterpretable in 4.4% of cases. A median number of two passes were required for LEEP excision of the transformation zone. The number of passes correlated with the amount of thermal artifact detected (P=.034). Regarding recurrence patterns, normal follow-up cervical cytology was similar for both groups: 96.7% in the LEEP group vs. 100% in the cold knife conization group. CONCLUSION: We conclude that LEEP is an acceptable diagnostic alternative to traditional cold knife conization. Thermal artifact remains a disadvantage that can be minimized by limiting the number of passes required to obtain a complete specimen.

Original languageEnglish (US)
Pages (from-to)1007-1014
Number of pages8
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Issue number12
StatePublished - Dec 1 1998


  • Biopsy
  • Cervix neoplasms
  • Cold knife conization
  • LEEP
  • Loop electrosurgical excision procedure

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine


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