A major advantage of LEEP is the removal of abnormal tissue while providing an adequate specimen for pathological study. Confirming complete removal of the lesion by observing specimen margins essentially eliminates the risk of missing microinvasive cancers. 36 In spite of the removal of tissue, the transformation zone heals with a normal appearance in the vast majority of patients, allowing for normal long-term cytologic and colposcopic follow-up. 1, 4
LEEP also offers the advantage of being a clinic procedure performed under local anesthesia. Treatment of even advanced lesions can be accomplished with the complete removal of the transformation zone or conization, with result comparable to knife conization. 1, 2, 6, 22, 24
Several studies show that colposcopy directed biopsy may underestimate the severity of cervical lesions between 12 and 25.5 percent of the time when compared to LEEP specimens. 10, 11, 12, 31, 36, 37, 38 There also is evidence that microinvasive carcinoma has been missed on directed biopsy 2, 11, 36, 39 - 41 and ablative therapy. 13, 36, 42 Underestimation of severity can lead to improper use of simple ablative therapy, with the possibility of not eradicating the cancer. LEEP virtually eliminates this risk because it allows for histologic examination and complete removal of the tissue.
Cost is another major consideration. The LEEP unit usually costs $3,000
to $7,500. This expense is much less than laser equipment (between $50,000
and $80,000). 43 The cost of maintaining laser equipment may exceed $5000
per year. LEEP also saves the hospital and anesthesia costs of conization
in some cases. By improving diagnostic accuracy, LEEP may prevent the human
and financial cost of missing microinvasive cancer.
Return to LEEP Atlas Table of Contents
Return to LSUMC-S Clinical and Academic Medicine Home Page
Return to the LSUMC-S Home Page.
LSUMC-S Family Medicine. Write to us if you have comments or questions! EMayea@lsuhsc.edu