title: Diagnostic and therapeutic laser conization for cervical intraepithelial neoplasia.
abstract: OBJECTIVE
  The clinical efficacy of conservative treatment using Nd-YAG laser technique for cervical intraepithelial neoplasia (CIN) was evaluated in a large series of CIN patients based on the long-term follow-up results.
  
  
  METHODS
  We have treated 2107 women preoperatively diagnosed as having CIN by Nd-YAG contact laser conization with vaporization of the base. Their postoperative histologic findings and clinical outcomes were evaluated.
  
  
  RESULTS
  The cone specimen was reported as showing that 1956 (92.8%) of 2107 cases had no CIN or CIN 1-3 and 151 (7.2%) cases had invasive diseases. 1956 cases without invasive diseases were followed up for 16 to 252 months. Incomplete excision occurred in 230 (12.3%) of 1874 patients with CIN lesion in the cone specimen, but failure rate (persistence or recurrence) was only 1.2%. 192 (83.5%) of 230 postoperative CIN patients with positive surgical margins showed no abnormal cytology or colposcopy during follow-up period. Preoperative underdiagnosis of biopsy results compared with cytologic or colposcopic findings elevated the risk for incomplete excision and failure rate.
  
  
  CONCLUSIONS
  The combination of laser excision and vaporization of the base was useful to detect unexpected invasive disease and revealed excellent therapeutic effects for CIN. Preoperative cytologic or colposcopic findings should be taken into account for the conservative treatment of CIN.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka Medical College, Takatsuki, Osaka 569-8686, Japan.gyn017@poh.osaka-med.ac.jp
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Ueda
authors.forename: Ken
authors.initials: K
authors.lastname: Ueki
authors.forename: Masanori
authors.initials: M
authors.lastname: Kanemura
authors.forename: Shinji
authors.initials: S
authors.lastname: Izuma
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Koji
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Terai
authors.forename: Minoru
authors.initials: M
authors.lastname: Ueki
mesh_terms: D019092:Conization / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*