Dena J. Kaufman, Cheryl L. Straub-Morarend, Addy C.
Introduction: Surgical options for cervical intraepithelial neoplasia vary in the reduced risk of recurrence. This systematic literature review investigated the effectiveness of cold knife conization and loop electrosurgical excision procedure for the reduction of neoplastic recurrence in women with cervical intraepithelial neoplasia.
Methods: A literature search of PubMed, the Cochrane Database of Systematic Reviews, and Turning Research Into Practice between January and March 2019 resulted in two systematic reviews, one meta-analysis, and two retrospective cohort studies for analysis. Studies included women with cervical intraepithelial neoplasia, compared cold knife conization and loop electrosurgical excision procedure, reported neoplastic recurrence and were published in English within the past ten years. Critical appraisal was performed utilizing the Centre for Evidence-Based Medicine’s Critical Appraisal Worksheets.
Results: Four of five included studies favored cold knife conization over loop electrosurgical excision procedure for reduction of recurrence. One article was considered to be of moderate-to-high quality, two of moderate quality, one of low-to-moderate quality, and one of low quality.
Conclusion: The data provided weak but pertinent evidence supporting the use of cold knife conization over loop electrosurgical excision procedure for reduction of recurrence. Further research is advised to affirm the findings of this review and to explore additional treatment options.
Cervical intraepithelial neoplasia (CIN), Cold knife conization (CKC), Loop electrosurgical excision procedure (LEEP), Neoplastic recurrence