{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T19:08:50Z","timestamp":1770145730993,"version":"3.49.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>The aim of this study is to analyze a quality assurance program regarding the switch from loop electrosurgical excision procedure (LEEP) in general anesthesia (GA) to local anesthesia (LA) regarding patients\u2019 perioperative pain levels, patients\u00b4 satisfaction, as well as resection margins.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We performed a single-center retrospective analysis of our quality assurance program including all patients undergoing LEEP at the Department of Obstetrics and Gynecology, Ordensklinikum Linz and Konventhospital Barmherzige Brueder Linz, from January 2021 to June 2024. 435 patients were questioned postoperatively after being treated with LEEP in LA regarding the perioperative pain as measured by a numeric rating scale (NRS) and patients\u2019 satisfaction. Clinical data were collected from the patients\u2019 electronic chart to investigate further parameters.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Mean perioperative pain levels were stated as 1.3 (1.9). Five perioperative complications were reported. In seven out of 435 cases (1.6%) an inpatient readmission or a revision surgery under GA had to be performed. A R0 resection rate of 81.4% could be achieved. In 9.7% and 8.3% a R1 resection rate was reported on the ectocervix and on the endocervix, respectively. 95.3% of patients would choose LEEP in LA as their preferred method of anesthesia for a possible subsequent surgical LEEP procedure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Our study showed that the implementation of LEEP in LA was successful at our department as a new standard of care, resulting in a high R0 resection status and a high level of patients\u2019 satisfaction. We encourage physicians and organizations to switch from GA to LA when performing LEEP for cervical dysplasia.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00404-025-08060-0","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T08:12:14Z","timestamp":1747987934000},"page":"621-625","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Loop electrosurgical excision procedure (LEEP) under local anesthesia: a retrospective analysis of 435 subsequent cases under a quality assurance program"],"prefix":"10.1007","volume":"312","author":[{"given":"Ulrike","family":"Binder","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Wenzl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Lafleur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemens","family":"Tempfer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3353-3466","authenticated-orcid":false,"given":"Lukas","family":"Hefler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"8060_CR1","doi-asserted-by":"publisher","unstructured":"Martin-Hirsch PP, Paraskevaidis E, Bryant A, Dickinson HO, Keep SL (2010) Surgery for cervical intraepithelial neoplasia. Cochrane Database of Systematic Reviews, Issue 6. Art No: CD001318. https:\/\/doi.org\/10.1002\/14651858.CD001318.pub2","DOI":"10.1002\/14651858.CD001318.pub2"},{"key":"8060_CR2","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1007\/s00404-022-06680-4","volume":"307","author":"A Ehret","year":"2023","unstructured":"Ehret A, Bark VN, Mondal A, Fehm TN, Hampl M (2023) Regression rate of high-grade cervical intraepithelial lesions in women younger than 25 years. Arch Gynecol Obstet 307:981\u2013990. https:\/\/doi.org\/10.1007\/s00404-022-06680-4","journal-title":"Arch Gynecol Obstet"},{"key":"8060_CR3","unstructured":"Bundesministerium Arbeit, Soziales, Gesundheit, Pflege und Konsumentenschutz (2024) Humane Papillomaviren. https:\/\/www.sozialministerium.gv.at\/Themen\/Gesundheit\/Uebertragbare-Krankheiten\/Infektionskrankheiten-A-Z\/Humane-Papillomaviren-(HPV).html#. Accessed 19 April 2025"},{"key":"8060_CR4","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1007\/s00292-011-1480-9","volume":"32","author":"W K\u00fchn","year":"2011","unstructured":"K\u00fchn W (2011) Colposcopy in the diagnosis of early cervical cancer. Pathologe 32:497\u2013504. https:\/\/doi.org\/10.1007\/s00292-011-1480-9","journal-title":"Pathologe"},{"key":"8060_CR5","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1055\/s-0030-1271008","volume":"71","author":"G Cichon","year":"2011","unstructured":"Cichon G, K\u00fchn W, Schneider A (2011) Einfluss von Konisationen auf die Fr\u00fchgeburtenrate in Deutschland. Geburtshilfe Frauenheilkd 71:282\u2013284. https:\/\/doi.org\/10.1055\/s-0030-1271008","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"8060_CR6","unstructured":"Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF) (2020) Pr\u00e4vention des Zervixkarzinoms, Langversion 1.1. https:\/\/register.awmf.org\/assets\/guidelines\/015-027OLl_Praevention_Zervixkarzinom_2020-03-verlaengert.pdf. Accessed 19 April 2025"},{"key":"8060_CR7","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1111\/j.1479-828X.2012.01420.x","volume":"52","author":"A Borbolla Foster","year":"2012","unstructured":"Borbolla Foster A, Symonds I (2012) A comparative study of efficacy and outcomes of large loop excision of the transformations zone procedure performed under general anaesthesia versus local anaesthesia. Aust N Z J Obstet Gynaecol 52:128\u2013132. https:\/\/doi.org\/10.1111\/j.1479-828X.2012.01420.x","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"8060_CR8","unstructured":"NHS England (2024) Colposcopic diagnosis, treatment and follow up. https:\/\/www.gov.uk\/government\/publications\/cervical-screening-programme-and-colposcopy-management\/3-colposcopic-diagnosis-treatment-and-follow-up. Accessed 19 April 2025"},{"key":"8060_CR9","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/j.ijgo.2015.07.038","volume":"132","author":"Santesso N, Mustafa RA, Sch\u00fcnemann HJ, Arbyn M, Blumenthal PD, Cain J, Chirenje M, Denny L, De Vuyst H, Eckert LO, Forhan SE, Franco EL, Gage JC, Garcia F, Herrero R, Jeronimo J, Lu ER, Luciani S, Quek SC, Sankaranarayanan R, Tsu V, Broutet N, Guidline Support Group","year":"2016","unstructured":"Santesso N, Mustafa RA, Sch\u00fcnemann HJ, Arbyn M, Blumenthal PD, Cain J, Chirenje M, Denny L, De Vuyst H, Eckert LO, Forhan SE, Franco EL, Gage JC, Garcia F, Herrero R, Jeronimo J, Lu ER, Luciani S, Quek SC, Sankaranarayanan R, Tsu V, Broutet N, Guidline Support Group (2016) World Health Organization Guidelines for treatment of cervical intraepithelial neoplasia 2\u20133 and screen-and treat strategies to prevent cervical cancer. Int J Gynaecol Obstet 132:252\u2013258. https:\/\/doi.org\/10.1016\/j.ijgo.2015.07.038","journal-title":"Int J Gynaecol Obstet"},{"key":"8060_CR10","doi-asserted-by":"publisher","first-page":"888.e1","DOI":"10.1016\/j.ajog.2020.06.041","volume":"223","author":"GA Rezniczek","year":"2020","unstructured":"Rezniczek GA, Hecken JM, Rehman S, Dogan A, Tempfer CB, Hilal Z (2020) Syringe or mask? Loop electrosurgical excision procedure under local or general anesthesia: a randomized trial. Am J Obstet Gynecol 223:888.e1\u20139. https:\/\/doi.org\/10.1016\/j.ajog.2020.06.041","journal-title":"Am J Obstet Gynecol"},{"key":"8060_CR11","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.jogoh.2016.12.006","volume":"46","author":"A Mercuzot","year":"2017","unstructured":"Mercuzot A, Chevreau J, Sevestre H, Muszynski C, Arbyn M, Sergent F, Gondry J (2017) Impact of anaesthesia mode on evaluation of LEEP specimen dimensions. J Gynecol Obstet Hum Reprod 46:339\u2013342. https:\/\/doi.org\/10.1016\/j.jogoh.2016.12.006","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"8060_CR12","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/j.1365-2303.2010.00824.x","volume":"22","author":"YL Woo","year":"2011","unstructured":"Woo YL, Badley C, Jackson E, Crawford R (2011) Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia. Cytopathology 22:334\u2013339. https:\/\/doi.org\/10.1111\/j.1365-2303.2010.00824.x","journal-title":"Cytopathology"},{"key":"8060_CR13","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1111\/j.1471-0528.2010.02501.x","volume":"117","author":"SV Phadnis","year":"2010","unstructured":"Phadnis SV, Atilade A, Young MPA, Evans H, Walker PG (2010) The volume perspective: a comparison of two excisional treatments for cervical intraepithelial neoplasia (laser versus LLETZ). BJOG 117:615\u2013619. https:\/\/doi.org\/10.1111\/j.1471-0528.2010.02501.x","journal-title":"BJOG"},{"key":"8060_CR14","doi-asserted-by":"publisher","first-page":"2399","DOI":"10.1016\/j.pain.2011.07.005","volume":"152","author":"MA Ferreira-Valente","year":"2011","unstructured":"Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP (2011) Validity of four pain intensity rating scales. Pain 152:2399\u20132404. https:\/\/doi.org\/10.1016\/j.pain.2011.07.005","journal-title":"Pain"},{"key":"8060_CR15","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1177\/15589447221120846","volume":"19","author":"Z Model","year":"2024","unstructured":"Model Z, Benavent KA, Zhang D, Blazar PE, Earp BE (2024) Factors influencing patient preference for anesthesia in ambulatory hand surgery. HAND 19:306\u2013310. https:\/\/doi.org\/10.1177\/15589447221120846","journal-title":"HAND"},{"key":"8060_CR16","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s00101-005-0917-z","volume":"55","author":"A M\u00fcllender","year":"2006","unstructured":"M\u00fcllender A, Melichar G, Schmucker P, H\u00fcppe M (2006) Psychological traits, course of surgery and recovery following hernia repair in patients preferring general or local anesthesia. Anaesthesist 55:247\u2013254. https:\/\/doi.org\/10.1007\/s00101-005-0917-z","journal-title":"Anaesthesist"}],"container-title":["Archives of Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-025-08060-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00404-025-08060-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-025-08060-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T17:12:49Z","timestamp":1754673169000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00404-025-08060-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":16,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["8060"],"URL":"https:\/\/doi.org\/10.1007\/s00404-025-08060-0","relation":{},"ISSN":["1432-0711"],"issn-type":[{"value":"1432-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,23]]},"assertion":[{"value":"3 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflicts of interest to declare that are relevant to the content of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Approval for this study was obtained by the respective Institutional Review Board of the Medical University Linz (Johannes Kepler Universit\u00e4t, JKU) on the 15.01.2025 (EK 1345\/2024). The study was performed in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}