Is the Loop Electrosurgical Excision Procedure Necessary for Minor Cervical Cytological Abnormalities?


Background: To investigate the indications of loop electrosurgical excision procedure (LEEP) and itsovertreatment rates for the see and treat and three step strategies in cases of atypical squamous cells ofundetermined cytology (ASC-US) and low grade intraepithelial neoplasia (LGSIL) cytology. Materials and
Methods: We retrospectively analyzed colposcopy directed biopsy (CDB) and LEEP results of 176 paients withASC-US or LGSIL cytologies who underwent colposcopic examination.
Results: Initial cytologies were ASCUSin 120 women and LGSIL in 56. According to the see and treat approach immediate LEEP was performed for38women. Among the remaining 138 women, LEEP was performed for 32 whose CDB results revealed CIN2/3lesions. In the see and treat group the recognition of CIN2/3 was found to be 39.4%. The overtreatment rate was60% as compared to 25% in the three step group. In CDB group detection of CIN 2 or greater lesions increasedwith 3 or more biopsies.
Conclusions: In patients with ASC-US/LGSIL cytologies CDB should be performedbefore LEEP to prevent overtreatment, with attention to all suspected areas and more than 2 biopsies taken.