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Radiofrequency versus monopolar electrosurgical conization for cervical precancerous lesions: A retrospective cohort
1Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, the Republic of Korea.
Objective:
To compare the perioperative, histopathologic, and oncologic outcomes of radiofrequency (RF) conization and monopolar electrosurgical (ME) conization in women with cervical precancerous lesions.
Study Design:
We retrospectively reviewed consecutive patients who underwent cervical conization between 2014 and 2026 at a single tertiary referral center. Patients underwent conization using either a 4-MHz RF electrosurgical system or a conventional ME system. The electrosurgical system was selected according to device availability at the given time and location, per routine institutional practice. Primary outcomes included perioperative outcomes (operative time, intraoperative hemostatic suturing, postoperative complications) and histopathologic outcomes (cone dimensions, resection margin status, and specimen fragmentation). Secondary outcomes included recurrence and high-risk human papillomavirus (HPV) clearance.
Results:
A total of 689 patients were included (RF, n = 325; ME, n = 364). Baseline characteristics were similar between the groups. The incidence of postoperative vaginal bleeding was comparable (RF, 12.6%; ME, 12.1%; P = 0.834), as were intraoperative hemostatic suturing, resection margin involvement (RF, 12.9%; ME, 12.6%), specimen fragmentation (RF, 28.9%; ME, 27.7%), recurrence (RF, 4.6%; ME, 4.1%), and high-risk HPV clearance. No significant differences were observed in any perioperative, histopathologic, or oncologic outcome.
Conclusion:
No significant differences in perioperative, histopathologic, or oncologic outcomes were observed between radiofrequency and monopolar electrosurgical conization, suggesting that radiofrequency electrosurgery may represent a practical alternative for cervical conization.
Precis:
No significant differences in perioperative, histopathologic, or oncologic outcomes were observed between radiofrequency and monopolar electrosurgical conization.
