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Long-term outcome of a randomized study comparing three techniques of conization: cold knife, laser, and LEEP
Patrice Mathevet1, Elias Chemali, Michel Roy
1Department of Gynecology, Hôpital Edouard Herriot, Pavillon L, Place d'Arsonval, 69437 Cedex 03, Lyon, France. patrice.mathevet@chu-lyon.fr
Objective:
To evaluate the long-term recurrence rates and complication of different techniques of cervical ablation.
Methods:
A randomized trial of three techniques of conization (cold knife, laser, and loop electrosurgical excisional procedure (LEEP)) for cervical intraepithelial neoplasia (CIN) in which 110 patients had been recruited.
Results:
Eighty-six patients were followed-up for more than 3 years. Of these 28 had been treated with the cold knife, 29 with LEEP and 29 by laser. Five recurrences were observed, one in the cold knife group, two in the LEEP group and two in the laser group (P=NS). The only observed complication was cervical stenosis: zero cases in the laser group, one case in the LEEP group and four cases in the cold knife group (laser versus cold knife: P=0.03; LEEP versus cold knife: P=0.06). Fifty pregnancies were observed in 39 patients. First and second trimester outcomes of pregnancy were without complications. One patient treated with the LEEP presented with a premature rupture of membranes and premature labor at 36 weeks. A total of nine cesarean sections were performed with two cases for cervical dystocia.
Conclusion:
There is no major difference in obstetrical outcome between the three techniques.