title: Long term outcomes of laser conization for high grade cervical intraepithelial neoplasia in Thai women.
abstract: OBJECTIVE
  To report long term outcomes of laser conization for high grade cervical intraepithelial neoplasia (CIN) in Thai women.
  
  
  METHODS
  A retrospective cohort study was conducted in patients undergoing laser conization due to abnormal cervical cytology suggesting neoplasia during 1989 to 1994 and having follow-up data until December 2010. Conization was performed under colposcopy using a 0.5-mm CO2 laser beam with power density of 18,000-20,000 watts/cm2, and the surgical base was vaporized using a low power defocused beam. The follow-up protocol included cervical cytology and colposcopy. Long term outcome measures were failure rate (persistence and recurrence), post-conization status of transformation zone, and obstetric outcomes.
  
  
  RESULTS
  Of 104 patients undergoing conization, 71 had therapeutic conization for high grade CIN and were followed up for a median time of 115 (range 12-260) months. There was one case of persistent and one of recurrent disease comprising a failure rate of 2.8%. The post treatment transformation zone was well visualized in 68.3% of 63 patients with an intact uterus. Sixteen patients achieved 25 pregnancies; none had second trimester miscarriage. The obstetric outcomes were unremarkable.
  
  
  CONCLUSIONS
  Laser conization under colposcopic visualization for the treatment of high grade CIN in Thai women has a low failure rate of 2.8%. The post-conization transformation zone could not be evaluated completely in approximately 30% of cases; therefore the follow-up protocol should include both cytology and colposcopy. Obstetric outcomes are not adversely affected by this therapeutic procedure.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand E-mail : sislj@yahoo.com.
authors.forename: Weerasak
authors.initials: W
authors.lastname: Wongtiraporn
authors.forename: Somsak
authors.initials: S
authors.lastname: Laiwejpithaya
authors.forename: Suthi
authors.initials: S
authors.lastname: Sangkarat
authors.forename: Mongkol
authors.initials: M
authors.lastname: Benjapibal
authors.forename: Manee
authors.initials: M
authors.lastname: Rattanachaiyanont
authors.forename: Irene
authors.initials: I
authors.lastname: Ruengkhachorn
authors.forename: Pattama
authors.initials: P
authors.lastname: Chaopotong
authors.forename: Sujera
authors.initials: S
authors.lastname: Laiwejpithaya
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D003127:Colposcopy; D019092:Conization / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013785:Thailand; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*