[Complications, sequellae and outcome of cervical conizations: evaluation of three surgical technics]

To assess complications and after-effects of conizations and follow-up of patients treated with 3 conization methods. Materials and methods. Two hundred and forty-one conizations were performed for cervical dysplasia using cold knife (100 cases), electric knife (39 cases) or loop electrosurgical excision (102 cases). Residual disease, post-operative bleeding, cervical stenosis and recurrences were assessed.

The height of the cone biopsy specimen was higher after cold knife conization (18.3 4.7 mm) and electric knife conization (18.4 0.7 mm) than after loop electrosurgical excision (12.8 3.5 mm) (P<0.001). However, the rate of positive margins for dysplasia was not significantly different: 7%, 8% and 14%, respectively. The rate of post-operative bleeding was 8%, 5% and 2%, respectively. The rate of cervical stenosis was 8%, 27% and 3%, respectively (P<0.001). The rate of recurrences was not significantly different: 8%, 15% and 11%, respectively.

Taking into account the current trend not to repeat surgery systematically after positive margin conizations, the risk of bleeding after cold knife conization, the risk of stenosis after electric knife conization and excessive depth of cone excision, the loop electrosurgical procedure may be recommended as a first option to treat cervical dysplasia.