Laser and cold-knife conisation for cervical intraepithelial neoplasia: a long-term follow-up

The study was designed to compare the follow-up results after laser and cold-knife conisation. In both groups 28 patients were included matched for age and parity. All had histologically verified cervical intraepithelial neoplasia (CIN) 3. Laser conisation was performed using a CO2 laser attached to a handpiece. The same surgeon treated all patients. Follow-up consisted of cytology and colposcopy after 3, 12, 24, 36, 48 and 60 months.There were no intra- or postoperative complications. Recurrence or residual disease was found in 7% in both groups. In the laser group, in six patients the histological interpretation of extension of CIN in the excision margin was not reliable, compared to one case in the cold-knife group. The number of inconclusive colposcopy in the laser group is one out of 26 compared to the cold-knife group 17 out of 24 after 60 months.The major advantage of using a CO2 laser for conisation of the cervix in cases of CIN is the reliability of the colposcopic examination.