title: Procedures of cervical conization: a national survey among Italian colposcopy units.
abstract: BACKGROUND
  The recent evolution of surgical techniques, anesthesia and treatment strategies has led to a decrease in the number of cervical conization procedures performed in ordinary hospitalization or with anesthetics other than local infiltration anesthesia of the cervix. Conization should be as least invasive as possible, favor women's compliance and resumption of normal daily activities after surgery. We evaluated various aspects of patient care revolving around conization (technical, healthcare, and administrative aspects) in the clinical practice of 26 Italian colposcopy units.
  
  
  METHODS
  A standard multiple-choice questionnaire was used. The retrospective study covered a period of 10 years.
  
  
  RESULTS
  The overall number of conization procedures performed over the 10 years' observation period ranged from 20,000 to 37,500. The techniques used were the loop electrosurgical excision procedure in 79.9% of cases, CO2 laser in 16.7%, and the cold-knife biopsy in 3.4%. An outpatient regimen was reported in 62.1% of cases, a day-surgery regimen in 35.2% and an ordinary hospitalization in 2.7%. Local anesthesia, deep sedation and general anesthesia were usually performed in 86.7%, 11.9% and in 1.4% of cases, respectively. The use of prophylactic antibiotics was common only in 8% of cases. The rate of major adverse events recorded over the observed period varied between 0.04% and 0.02% (15,000-29,000 conizations).
  
  
  CONCLUSIONS
  The administrative regimen in which conizations are performed is an expression of behaviors of different health authorities and hospitals in relation to the costs that this procedure entails.
authors.affiliation: Gynecological Oncology Unit, Oncology Referral Center, National Cancer Institute, Aviano, Italy - ciavattini.a@libero.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sopracordevole
authors.forename: Jacopo
authors.initials: J
authors.lastname: DI Giuseppe
authors.forename: Francesca
authors.initials: F
authors.lastname: Mancioli
authors.forename: Giovanni
authors.initials: G
authors.lastname: DE Piero
authors.forename: Monica
authors.initials: M
authors.lastname: Buttignol
authors.forename: Andrea
authors.initials: A
authors.lastname: Ciavattini
mesh_terms: D000758:Anesthesia / Q000379:methods; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery*; D003080:Cold Temperature; D003127:Colposcopy; D019092:Conization / Q000379:methods* / Q000706:statistics & numerical data; D004598:Electrosurgery / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007558:Italy; D054020:Lasers, Gas / Q000627:therapeutic use*; D005791:Patient Care / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies