Role of Loop Electrosurgical Excision Procedure in the Management of Precancerous Lesions of the Cervix in Developing Countries

Pambou O1,2,3, Mokondjimobe E2,3, Baleka AM4, Essimo JM4. Longo-Mbenza B3,5,6* and Lusunsi CK3

1Private Hospital in West Paris, University of Versailles Saint-Quentin-en-Yvelines, France
2Marien Ngouabi University, Republic of Congo
3Department of Public Health, Lomo University of Research, Democratic Republic of Congo
4Department of Gyneco-obstetrics, University of Kinshasa, Democratic Republic of Congo
5Department of Internal Medicine, University of Kinshasa, Democratic Republic of Congo
6Walter Sisulu University, South Africa

^*Correspondance to: Benjamin Longo-Mbenza 

 PDF  Full Text DOI: 10.25107/2474-1647.3630

Abstract

Purpose: The Human Papillomavirus (HPV) causes 80% of cases of cervical cancer. The World Health Organization recommends the use of cryotherapy or Loop Electrosurgical Excision Procedure (LEEP) for treating these lesions. This study evaluated the role of LEEP in developing countries and aimed to demonstrate that excision of high-grade cervical precancerous lesions by LEEP is simple, reproducible, inexpensive. Patients and Methods: This non-randomized observational analytical retrospective study was performed for over 4 years in patients who underwent cervico-vaginal smears and HPV tests during gynecology consultation at the Private Hospital of Western Paris (PHWP) in France. Patients with pathological smear and HPV positivity were directed to colposcopy biopsy. Cervical Intraepithelial Neoplasia (CIN) 2 and 3 lesions were treated by LEEP under local and ambulatory anesthesia. R Environment and Excel version 2018 were used for statistical analysis. Results: 167 pathological smear positive cases (13.17%) were sent for colposcopy biopsy. HPV16 was the most frequently encountered virus (80%). More than 50% of pathological smears showed low grade atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesions/CIN 1 lesions (41.9%). Patients with high-grade squamous intraepithelial lesions (CIN 2 and 3) (7.7% cases) were treated with LEEP; 2 had adenocarcinoma in situ and 1 squamous cell cancer. The resection margins were healthy in 99% of cases; there were no surgical or anesthetic complications in our study and no recurrence was observed in 4 years. Conclusion: Precancerous lesions (including CIN 2 and 3) of the cervix were treated by LEEP without complications or recurrences in 4 years. This simple, reproducible, and affordable surgical technique could be taught and adapted in under-equipped practices to reduce the incidence of invasive cervical cancer.

Keywords

Precancerous lesions of the cervix; LEEP; Developing countries

Cite the article

Pambou O, Mokondjimobe E, Baleka AM, Essimo JM, Longo-Mbenza B and Lusunsi CK. Role of Loop Electrosurgical Excision Procedure in the Management of Precancerous Lesions of the Cervix in Developing Countries. Clin Surg. 2023; 8: 3630..