Evaluation of the results of loop electrosurgical excision procedure surgical margin positivity and recurrence

Objectives: Loop electrosurgical excision procedure (LEEP), which is effectively used in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN), can be performed under general and local anesthesia. The aim of this study is to retrospectively examine whether the chosen anesthesia method affects the surgical margin and the factors affecting the surgical margin. Materials and Methods: Data of 122 patients who met the inclusion criteria and underwent LEEP between 2016 and 2021 were retrospectively analyzed. Demographic data (age, body mass index, alcohol and smoking); gynecological anamnesis: Gravida, parity, number of living children, number of abortions, menopausal status, type of contraceptive method and presence of additional metabolic diseases (hypertension, diabetes, coronary artery disease) were recorded from the patients’ files and epicrisis. LEEP indications and pre-LEEP HPV information were recorded. LEEP procedure data: Anesthesia method used; general or local anesthesia, positive surgical margin rate (for example, the presence of CIN II/III at the ectocervical and/or endocervical resection margins was considered positive), size of the removed piece (anteroposterior length, transverse length and height, volume), pathology results were recorded and factors affecting margin positivity were examined. Results: It was determined that the type of anesthesia administered (general or local), patient age older than 40 years, patient being in menopause, and the size and volume of the sample taken during LEEP had no effect on margin positivity, whereas high-grade cervical cytology before LEEP, the presence of endocervical gland involvement, and the number of multiple passes in the excision were shown to increase the risk for margin positivity. Conclusion: We found that high-grade cervical cytology before LEEP, the presence of endocervical gland involvement, and multiple passes in excision were risk factors predicting a positive surgical margin; however, the type of anesthesia did not affect the surgical margin.