Difference between revisions of "Loop electrosurgical excision procedure"

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'''Loop electrosurgical excision procedure''', abbreviated '''LEEP''', is a gynecologic procedure to remove tissue from the [[uterine cervix]].<ref>URL: [http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes]. Accessed on: 13 August 2012.</ref>  It is used to diagnose, stage and treat cervical neoplasia.
'''Loop electrosurgical excision procedure''', abbreviated '''LEEP''', is a gynecologic procedure to remove tissue from the [[uterine cervix]].<ref>URL: [http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes]. Accessed on: 13 August 2012.</ref>  It is used to diagnose, stage and treat cervical neoplasia.


==Work-up of a negative LEEP==
==Negative LEEP==
#Review the biopsy that triggered the LEEP.
Definition:
*LSIL or NILM, on a LEEP prompted by HSIL.<ref name=pmid23020732/>
 
Prevalence:
*Relatively common ~ 25% of cases in one larger series.<ref name=pmid23020732>{{Cite journal  | last1 = Witt | first1 = BL. | last2 = Factor | first2 = RE. | last3 = Jarboe | first3 = EA. | last4 = Layfield | first4 = LJ. | title = Negative loop electrosurgical cone biopsy finding following a biopsy diagnosis of high-grade squamous intraepithelial lesion: frequency and clinical significance. | journal = Arch Pathol Lab Med | volume = 136 | issue = 10 | pages = 1259-61 | month = Oct | year = 2012 | doi = 10.5858/arpa.2011-0494-OA | PMID = 23020732 }}</ref>
 
===Work-up===
#Review the biopsy that triggered the LEEP - check whether it is HSIL.
#Cut levels (x3) on all blocks.
#Cut levels (x3) on all blocks.
#Flip all the blocks and cut levels (x3).
#Flip all the blocks and cut levels (x3) on all the blocks.
#Do a p16 [[immunostain]] on the most suspicious block, if the triggering diagnosis was ''cannot exclude HSIL'', ''HSIL'' or ''SCC''.
#Do a p16 [[immunostain]] on the most suspicious block, if the triggering diagnosis was ''cannot exclude HSIL'', ''HSIL'' or ''SCC''.
#Sign out the thing as negative - see below.


==Sign out==
==Sign out==
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