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Re: Dysplasia ...... and a surprise From: Geffrey H. Klein, MD (gklein@bcm.tmc.edu) Sun Aug 31 20:00:19 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: ATFSOCCER@aol.com: "Re: Twins/uterine monitoring" Previous message: Garry E. Siegel, M.D.: "Re: Delivery mode in a patient with a previous rectovaginal fistula" In reply to: Robert Brenner: "Re: Dysplasia ...... and a surprise" >> >>I have to disagree. This endocervical lesion could have explained the >>positive ECC and the abnormal pap smears. > >Then can you be sure you got the endocervical lesion in its entirety. > No, but I cannot be sure that I got the entire lesion with a cold knife cone either. However, a LEEP procedure has been shown to be both diagnostic and therapeutic. So, if she were not going to get a laparotomy for colon surgery, follow-up with serial paps would, IMHO, be within standard of care.. >>I have heard this before from others, but I am confused. A LEEP is a >>cone. Why does performing the procedure with a knife make it better >>that with an electrical loop? My feeling is that doing A LEEP in the >>office is more cost effective than a cone in the hospital. I can't >>think of any situation where I would ever do a cold knife cone again... >>Is this wrong? > >A cold knife conization goes deeper than a leep. Also, there is no cautery >artifact so interpretation by the pathologist may be more accurate. A cold knife cone does go deeper than a LEEP? I can take as much or as little tissue with either technique. As for the cautery artifact, you may theoretically have a point, but I have never heard a pathologist complain or even comment about this.. ---------------------------------- Geffrey H. Klein, MD ---------------------------------- gklein@bcm.tmc.edu -- ---------------------------------- http://members.aol.com/gklein01/geff.html List-owner OB-GYN-L co-moderator sci.med.obgyn Advisory Board Chairman OBGYN.net http://www.obgyn.net/medical.htm Office: 2200 Nasa Rd #1 Houston, Texas 77058 Tel 713 741 2273 x2628 Next message: ATFSOCCER@aol.com: "Re: Twins/uterine monitoring" Previous message: Garry E. Siegel, M.D.: "Re: Delivery mode in a patient with a previous rectovaginal fistula" In reply to: Robert Brenner: "Re: Dysplasia ...... and a surprise"

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