Comparative Efficacy of Loop Electrosurgical Excision Procedure and Cold Knife Conization in Treating High-Grade Cervical Intraepithelial Neoplasia in Female Athletes: A Meta-Analysis for Sports Medicine Applications

Abstract

Objective: To evaluate the clinical effectiveness of cold knife conization (CKC) versus loop electrosurgical excision procedure (LEEP) in managing high-grade cervical intraepithelial neoplasia (HCIN) in female athletes, crucial for their health and performance continuity.

Methods: A comprehensive search was conducted in databases including the Cochrane Library, EMBASE, PubMed, CNKI, Wanfang, and VIP for randomized controlled trials comparing CKC and LEEP in the treatment of HCIN. Study quality was assessed using the Cochrane Handbook’s guidelines and the RevMan 5.3 software.

Results: Ten studies were analyzed, comprising 1180 participants split into control (595 patients) and study (585 patients) groups. No significant differences were found between CKC and LEEP in terms of residual lesion rates (RR=0.94, 95%CI 0.62-1.35, P > 0.05) and recurrence rates (RR=0.88, 95%CI 0.52-1.40, P > 0.05). However, LEEP resulted in lower rates of postoperative bleeding (RR=1.78, 95% CI 1.20-2.85, P < 0.05) and fewer instances of postoperative cervical stenosis or adhesion (RR=2.52, 95% CI 1.30-4.05, P < 0.01) compared to CKC.

Conclusion: Both CKC and LEEP demonstrate comparable effectiveness in treating HCIN without significant differences in lesion recurrence or residual rates. However, LEEP shows advantages in reducing postoperative complications such as bleeding and cervical stenosis, which are critical considerations for female athletes' recovery and return to sport. Clinicians should consider these findings when planning individualized treatment strategies for female athletes to ensure minimal disruption to their sports participation and performance.