OUTPATIENT CO2-LASER EXCISIONAL CONIZATION FOR CERVICAL INTRAEPITHELIAL NEOPLASIA UNDER LOCAL-ANESTHESIA

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.