Meta Analysis Of The Comparison Of Two Treatments For Cervical Intraepithelial Neoplasia-Loop Electrosurgical Excision Procedure And Cold Knife Conization

Objective:To evaluate the clinical efficacy of Loop Electrosurgical Excision Procedure(LEEP)and Cold Knife Conization(CKC)in the treatment of CIN by meta-analysis.Methods:All the published randomized controlled trial were obtained through the computerized search of Pubmed(From 1966 to December 31,2017),Embase(From 1974 to December 31,2017),Cochrane Library(December 31,2017),MEDLINE(From 1966 to December 31,2017),Science Direct(From 1985 to December 31,2017),CNKI(From 1994 to December 31,2017),wanfang Date system(From 1980 to December 31,2017)and Baidu scholar.All the work of exclusion,evaluation and collection data were undergoing through two independent investigators(Postgraduate).According to the latest score table of Jadad score,the quality of the final selected articles of the study and relevant data extraction.For dichotomous variables,outcomes were reported as relative risk ratio(RR)and 95% confidence interval(CI)was used to investigate the following outcome measures:Survival rate,recurrence rate,marginal positive rate,postoperative bleeding,postoperative infection,postoperative cervical stenosis or adhesions.for continuous variable data,outcomes were reported as weighted mean difference(WMD)and 95% confidence interval(CI)was used to investigate the following outcome measures:cone depth.The included literature is less heterogeneous,this study uses data from the fixed-effects model of Review manager software 5.3 which offered from the Cochrane Collaboration to analyze the data of comparison of two surgical treatments for cervical intraepithelial neoplasia.Results:13 randomized controlled trails involving 1715 patients were included.The experimental group(CKC group)and control group(LEEP group),CKC group 849 patients,LEEP group 866 patients.The results of Meta analysis showed that there was significant difference between CKC and LEEP in conization depth,postoperative bleeding,postoperative cervical stenosis or adhesion(P <0.05),while the recurrence rate,residual rate,marginal positive rate and postoperative infection showed no statistical difference(P> 0.05).Conclusion:CKC and LEEP compared to the treatment of CIN and postoperative infection rate similar efficacy,but LEEP has less postoperative bleeding,postoperative cervical stenosis or low incidence of adhesion advantages,more worthy of clinical recommendation.