Outpatient CO2 laser excisional conization for cervical intraepithelial neoplasia under local anesthesia.
OBJECTIVE
To evaluate the feasibility of CO2 laser excisional conization in patients with cervical intraepithelial neoplasia (CIN) in an outpatient setting under local anesthesia.


METHODS
A prospective study of women with cervical intraepithelial neoplasia over one year recording early and late complications, cure rate, and patients' compliance. 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 continuous beam.


RESULTS
The material included 81 women. Seventy-eight women were treated as outpatients, while three women were admitted for 24 hours observation due to surgical and technical complications during the treatment. Sixty-six percent of the women had bleeding less than 10 ml during the treatment. One woman was admitted 24 hours after surgery due to bleeding requiring suturing. Median operation-time was 11 minutes (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 found 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.


CONCLUSIONS
High success rate, few complications and high patient compliance make the procedure adequate as a routine procedure in treatment and diagnosis of CIN.
Department of Obstetrics and Gynecology, Central Hospital Naestved, Denmark.
P E
PE
Helkjaer
P S
PS
Eriksen
C F
CF
Thomsen
J
J
Skovdal
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000772:Anesthesia, Local; D016063:Blood Loss, Surgical; D002245:Carbon Dioxide; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*
D002245:Carbon Dioxide