A comparison study of cold knife and laser conization of the cervix : 10 years review

Abstract EN

-Objective : This retrospective study was designed to compare the outcome of cold knife and laser cones in the treatment of cervical intraepithelial neoplasia (CIN).

Methods : From 1985 to 1994, 357 patients had undergone cone biopsy for cervical intraepithelial neoplasia.

Group A : 213 (59 %) patients had a cold knife conization.

Group B: 144 (41 %) patients had conization by laser.

We compared Ga·oups A and B regarding the involvement of the upper and Io·wer margins, glandular extension and compromise of the endocervical canal and a positive endocervical curettage (ECC) after the cone.

Results: In group A, 33 (16%) patients had endocervical margins involved versus 26 (18 %) in group B (P = 0.57).

Ectocervicalmargin was involved in 39 (18 %) patients in group A versus 24 (16 %) patients in group B (P = O.

78).

Glandular extension was present in 54 (25 %) patients in group A versus 50 (34 %) patients in group B (P = 0.14).

Positive ECC after cone in 54 (25 %) patient~ in group A versus 9 (7%) patients in group B (P = < 0.001).

Thil"ty six patients had postconization hysterectomy, 22 without.

residual disease, 13 patients with ditl'erent dega·ees of CTN and one for adenocarcinoma in situ.

Conclusions: Laser cone is an easy technique that obtains a specimen as good as a cold knife cone.

The residual disease in the uterus was significantly lower with the laser technique when measured by positive ECC after the cone procedure.