A COMPARISON OF COLD KNIFE, CO2-LASER, AND ELECTROSURGICAL LOOP CONIZATION IN THE TREATMENT OF CERVICAL INTRAEPITHELIAL NEOPLASIA

Thirty patients with histologically confirmed high-grade squamous intr aepithelial lesions (SIL) were treated by either cold knife, laser, or electrosurgical loop conization, all of which were performed under ge neral anesthesia, The three methods were compared with respect to the immediate surgical complications, ease of performance, delayed complic ations, and quality of histologic specimens, The electrosurgical loop conization had decreased blood loss and reduced operative time and pro ved to be tissue sparing, There were no significant differences in the three groups in the persistence rates of cervical intraepithelial neo plasia (CIN) after treatment, Histologic analysis revealed comparable coagulation artifact in the laser and electrosurgical loop groups that the cold knife group did not have, The endocervical component of the electrocautery showed extensive denudation and coagulation artifact th at made recognition of CIN extremely difficult, We conclude that the e lectrocautery should be used only as an excisional method of the trans formation zone for lesions well defined on the ectocervix, since it is unreliable if the lesion extends into the endocervix.