Pe. Helkjaer et al., OUTPATIENT CO2-LASER EXCISIONAL CONIZATION FOR CERVICAL INTRAEPITHELIAL NEOPLASIA UNDER LOCAL-ANESTHESIA, Acta obstetricia et gynecologica Scandinavica, 72(4), 1993, pp. 302-306
Aim and objective. To evaluate the feasibility of CO2 laser excisional
conization in patients with cervical intraepithelial neoplasia (CIN)
in an outpatient setting under local anesthesia. Design. A prospective
study of women with cervical intraepithelial neoplasia over one year
recording early and late complications, cure rate, and patients' compl
iance. The procedure was performed with a Coherent CO2 laser connected
to the colposcope with a micromanipulator. The equipment attaining 19
,700 W/cm2, spot diameter 0.43 mm, focus distance 300 mm, and continuo
us beam. Results. The material included 81 women. Seventy-eight women
were treated as outpatients, while three women were admitted for 24 ho
urs observation due to surgical and technical complications during the
treatment. Sixty-six percent of the women had bleeding less than 10 m
l during the treatment. One woman was admitted 24 hours after surgery
due to bleeding requiring suturing. Median operation-time was 11 minut
es (range 3-60). All specimens contained CIN. In 76% of the cases the
pre- and postoperative diagnosis were identical. Twelve specimens had
CIN in one or both margins. Abnormal cytology after conization was fou
nd in three cases (4.2%). High patient compliance was found as 92% of
the treated women would choose the same kind of treatment if it had to
be repeated. Conclusion. High success rate, few complications and hig
h patient compliance make the procedure adequate as a routine procedur
e in treatment and diagnosis of CIN.