CO2-LASER CONIZATION FOR CERVICAL INTRAEPITHELIAL NEOPLASIA GRADE II-III - COMPLICATIONS AND EFFICACY

Aims. To examine per-and postoperative complication rates and efficacy of laser conization in the treatment of cervical intraepithelial neop lasia (CIN) grade II-III. Material and methods. Eligible for analyses were all women treated with their first laser conization because of CI N II-III during the time-period January 1, 1983 to December 31, 1992. The study population comprises 1081 women who were permanent residents of one Norwegian county (Sor-Trondelag). All analyses were performed in SPSS applying chi-square for trend, Mann-Whitney test, survival ana lyses and logistic regression. Results. In total 86 women (8.0%) were observed with one or two (4:86) complications. Bleeding was most frequ ent (n=66) followed by symptomatic cervical stenosis (n= 18). Most ble eding complications (74.2%) occurred one to two weeks postoperatively. Both bleeding complications and the occurrence of cervical stenosis w ere associated with cone height. Three emergency hysterectomies, two f or bleeding and one for bladder perforation, were performed. Persisten t disease was diagnosed in 1.9% (20:1053) of the women. All women with persistent disease were diagnosed among those with CIN III. Persisten t disease was more than 20 times more common among women with disease- involved resection margins compared to those with free resection margi ns. Conclusions. Our evaluation of ten years' consistent use of coniza tion by CO2 laser in the treatment of CIN II-III in an unselected popu lation showed a low overall complication rate (8%) and very high effic acy (CIN II 100%, CIN III 98.1%) of the treatment.