CO2 laser conization versus conventional conization: a clinico-pathologic appraisal

Two groups of patients recently underwent either laser or conventional conization at the University Women's Hospital in Bern, Switzerland. Of the total 49 patients treated, 25 underwent laser conization and 24 underwent conventional conization. All patients admitted to the study had cytologic, colposcopic, and/or histologic evidence for cervical intraepithelial neoplasia or chronic cervicitis resistant to conservative therapy. In the conventionally treated group, conization was performed with surgical scalpel, and hemostasis was achieved by Sturmdorff, Bonney, or Kraus sutures. In the laser-treated group, conization was performed by using the combination method of Dorsey and Grundsel. Blood loss was minimal in the laser-coned patients, compared to 119 ml blood loss in the conventionally coned patients. Hospitalization for the laser-treated group was 5.2 days in contrast to 7.0 days for the conventionally treated group. Postoperative bleeding and discharge were also considerably smaller or did not occur in the laser-treated group as compared to the conventionally treated group. With postoperative and long-term follow-up now under way, initial results indicate that laser conization, in comparison to conventional conization, also provides greater visibility of the squamocolumnar junction and a reduced incidence of cervical strictures. The results of this study suggest that the CO2 laser beam, properly and cautiously applied, is an efficacious surgical modality for the treatment of cervical preneoplastic disease.