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Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index
Online ISSN 1827-1650
Diotallevi F. F., Iacovelli A., Vincenzoni C., Atlante M.
Background. Evalutation of the efficacy of laser conization for cervical high-grade squamous intraepithelial lesions (Hg-SIL).
Methods. A retrospective evaluation. Case collection: A total of 77 women, 47 outpatients and 30 inpatients with endocervical CIN3 or CIN2, were treated by carbon dioxide (CO2) laser between 1993 and 1995. A preoperative diagnosis has been made by means of Pap-smear, colposcopy and marked biopsy. In 47 cases a laser conization was performed in Day Surgery, without vessel constrictors or local anesthetics. In 30 cases a narcosis (Diprivan) was induced. The former were discharged 2-3 hours and the latter 24 hours after treatment.
Results. The histological examination confirmed preoperative diagnosis in 64 (86.5%) cases and negligible one grade discrepancy was reported in 7 cases (6 over- and 1 underestimated); missed invasion and no free margins were reported in the remaining 4 and 2 patients respectively, so these latter 6 patients were submitted to other surgical procedures. No serious complications occurred with the exception of mild vaginal postoperative bleeding. During the follow-up of 36-82 months, cervical alterations were described only in 12 out of 71 cases, flat condilomatosy in 8 cases, CIN2 in 2 patients and CIN3 in other 2 patients. At present, all the patients are free of disease.
Conclusions. The conization with dioxide laser is a good therapy for cervical intraepithelial neoplasia, even if expensive; infact poor side-effects are observed as well as a very good reliability.