Cervical cancer is the 4th leading cause of cancer death in women and the 4th most frequently diagnosed cancer in women worldwide [1]. In the United States of America, estimates predict 14,000 new cases and 4,280 deaths in 2022 [2]. In France, it affects about 3000 women and causes 1100 deaths per year [3].

It is now well established that Human Papillomavirus (HPV) is the necessary factor leading to cervical cancer [4]. Knowledge of the oncogenesis of this pathology has allowed the establishment of a combined primary prevention program through vaccination and secondary prevention through organized population screening, with the ultimate goal of eradicating cervical cancer [5,6].

Early management of cervical intraepithelial neoplasia (CIN) is one of the pillars of cervical cancer prevention. For high-grade squamous intraepithelial lesion (HSIL), the recommended method is excisional treatment under continuous colposcopic control with the goal of removing the identified lesion and analyzing all of the removed tissue to avoid missing an infiltrative lesion [7]. The main side effect for women of childbearing age is premature delivery, which can be avoided by reducing the volume of the surgical specimen [8].

The major scientific societies recommend first-line removal of HSIL by the Loop Electro Excision Procedure (LEEP) [7,9,10]. However, it would appear that laser excision is an alternate surgical method as effective concerning negative surgical margins and post-operative clearance of HPV [11], [12], [13]. Few studies specifically compare these two techniques using these criteria.

The main objective of our study was to compare the laser excision method to LEEP by evaluating the quality of the margins on the surgical specimen (negative or positive). As secondary objectives, we studied factors associated with the status of the margins and depth of cones.