What is the difference between LEEP and conization?

LEEP and conization are two surgical methods for treating cervical lesions. Generally, LEEP and conization mainly differ in their principles, surgical techniques, indications, extent of resection, and postoperative recovery.

1. Principle: LEEP uses the instantaneous high heat generated by high-frequency radio waves to cut and coagulate tissue, whereas conization involves removing a cone-shaped piece of cervical tissue using a scalpel or other instruments.

2. Surgical Technique: LEEP is usually performed in an outpatient setting and is relatively simple to perform, typically without requiring sutures. In contrast, conization must be carried out in an operating room, generally under general or epidural anesthesia. It is a more complex procedure and requires suturing of the cervix after surgery.

3. Indications: LEEP is suitable for patients with cervical intraepithelial neoplasia (CIN) grade I or II, or CIN III with a small and superficial lesion. Conization is primarily indicated for patients with high-grade cervical intraepithelial neoplasia or cervical carcinoma in situ who wish to preserve fertility.

4. Extent of Resection: LEEP involves a relatively shallow and limited resection, targeting only the superficial diseased tissue of the cervix. In contrast, conization removes a cone-shaped tissue from the cervix, including part of the surface and endocervical tissue. It involves a larger resection area and greater depth, allowing for more comprehensive removal of diseased tissue.

5. Postoperative Recovery: Recovery after LEEP is relatively quick, with healing of the cervical wound generally taking about 2–3 months. However, because conization involves a larger resection area, the recovery period is longer, with cervical wound healing usually requiring 3–6 months.

Doctors typically consider a patient's specific condition, fertility requirements, and other factors comprehensively to select the most suitable surgical method.