title: Treatment of cervical dysplasia with the Fischer cone biopsy excisor in a family medicine office: a case series.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the use of the Fischer cone biopsy excisor (FCBE) as the primary electrode for treatment of cervical dysplasia in a family medicine office.
  
  
  METHODS
  Retrospective analysis of cervical electrosurgical excision procedures in patients with cervical intraepithelial neoplasia (CIN) performed in our Family Medicine Center between 2002 and 2005.
  
  
  RESULTS
  We reviewed 91 cases. Indication for excision was >or=CIN II in 86.8% of the patients. In the FCBE group (n = 86), 95% of the specimen margins were negative for dysplasia, 90% had no reported thermal artifact, and 81% were submitted unfragmented. In the FCBE and the loop electrosurgical excision procedure (LEEP) group (n = 5), 4 of the 5 specimens' margins were negative for dysplasia. Reported complications included palpitations or flushing during cervical block (32%), pain (9%), and heavy bleeding (3%).
  
  
  CONCLUSIONS
  In this case series the use of the FCBE with or without the LEEP in a family medicine office provided a high rate of negative margins for dysplasia and a low rate of fragmentation and thermal artifact. Family physicians who perform LEEP can also use the FCBE safely in their offices to treat cervical dysplasia.
authors.affiliation: Family Medicine Residency, William Beaumont Hospital, Troy, Michigan, USA. emulhem@beaumont.edu
authors.forename: Elie
authors.initials: E
authors.lastname: Mulhem
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Kennedy
authors.forename: David
authors.initials: D
authors.lastname: Lick
mesh_terms: D001706:Biopsy / Q000295:instrumentation*; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery; D003127:Colposcopy; D004598:Electrosurgery / Q000295:instrumentation*; D004867:Equipment Design; D005194:Family Practice / Q000193:education; D005260:Female; D006801:Humans; D007396:Internship and Residency; D009367:Neoplasm Staging; D010348:Patient Care Team; D016896:Treatment Outcome; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000601:surgery*; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*; D014626:Vaginal Smears