Laser and cold-knife conisation for cervical intraepithelial neoplasia: A long-term follow-up

The study was designed to compare the follow-up results after laser and col d-knife conisation. In both groups 28 patients were included matched for ag e and parity. All had histologically verified cervical intraepithelial neop lasia (CIN) 3. Laser conisation was performed using a CO2 laser attached to a handpiece. The same surgeon treated all patients. Follow-up consisted of cytology and colposcopy after 3, 12, 24, 36, 48 and 60 months. There were no intra- or postoperative complications. Recurrence or residual disease was found in 7% in both groups. In the laser group, in six patient s the histological interpretation of extension of CIN in the excision margi n was not reliable, compared to one case in the cold-knife group. The numbe r of inconclusive colposcopy in the laser group is one out of 26 compared t o the cold-knife group 17 out of 24 after 60 months. The major advantage of using a CO2 laser for conisation of the cervix in ca ses of CIN is the reliability of the colposcopic examination.