자궁경부병변에 있어서 Loop Electrosurgical Excision Procedure ( LEEP ) 의 진단 및 치료적 의의 = Efficacy of Loop Electrosurgical Excision Procedure ( LEEP ) in the Diagnosis and Treatment of Abnormal Cervical Lesions

다국어 초록 (Multilingual Abstract)

A group of 88 patients with abnormal cervical cytology underwent the Loop Electrosurgical Excision Procedure during the period from March, 1993 to January, 1994 at Korea University Kuro Hospital. This study was performed to assess the efficacy of LEEP in the diagnosis and treatment of abnormal cervical lesions. 1. The age distribution (in the years of age per decade) undergoing LEEP were 3.4% in the 2nd, 37.5% in the 3rd and 30.7% in the 4th decade, in which the 3rd and 4th decade took most of the age distribution. And the 5th and 6th decade took only 20.5% and 7.9% respectively. 2. The concordance rate of LEEP histology with cervical cytology was 59.1% (52 cases). In comparison to cervical cytology, the higher LEEP histologic rate was 26.1%(23 cases), and lower LEEP histologic rate was 14.8%(13 cases), respectively. 3. Of the 35 women with CIN III, only 5 women were reported with positive margin. Therefore a single therapy with LEEP proved effective in 30 women with CIN III(85.7%). 4. In 27 women with CIN III showing negaive margin, there was no evidence of persistent or recurrent disease during the 6 month follow-up. And in 3 women with CIN III showing positive margin who underwent LEEP a second time, there was also no recurrence. 5. The average wideth and depth of specimens was 26.5+-8.3 mm and 9.8+-2.1 mm, respectively. LEEP was also able to provide enough and proper specimen for pathologists, because the burned tissue diameter was less than 0.3 mm. 6. Complications of LEEP include discomfort in 8 women(9.1%), dizziness in 5 women (5.7%) and vaginal bleeding in the area of procedure in 12 women(13.6%). Of these women with vaginal bleeding, no one needed trasfusion, but those who needed hospital revisitation were 3(3.4%). With these results, it can be condluded that cervical conization with LEEP was advantageous with a shorter duration of surgery, simple to use under a local setting, reduced operative bleeding and less need for pain relieving medication. LEEP also provides good pathologic specimen, and hence, it can be considered a useful method in the diagnosis and treatment of abnormal cervical lesions.