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Thermal tissue damage following laser and large loop conization of the cervix
E Paraskevaidis1, H C Kitchener, V Malamou-Mitsi
1Department of Obstetrics and Gynecology, Ioannina Medical School, Greece.
Objective:
To compare thermal injury zones produced with laser and diathermy loop conization.
Methods:
Excisional cervical specimens (cones and cervices) were obtained from 40 consecutive women who underwent abdominal hysterectomy. The subjects were assigned to have either laser or diathermy loop conization (20 in each group). The duration of each procedure was recorded. Histopathologic measurements of thermal injury zones were performed in all specimens.
Results:
The techniques produced cone specimens of similar depth. The mean depth of thermal injury produced with laser conization in cone specimens (mean +/- standard deviation 0.49 +/- 0.16 mm) and cervical craters (0.58 +/- 0.24 mm) was significantly greater (P < .001) than the corresponding depth in cone specimens (0.22 +/- 0.09 mm) and cervical craters (0.27 +/- 0.11 mm) obtained by diathermy loop excision. The mean time of the two procedures was also significantly different (P < .001); laser conization 11 +/- 4.5 minutes and loop conization 2 +/- 1.2 minutes.
Conclusion:
For routine conization, loop diathermy causes less thermal damage to the specimen and is a faster procedure than laser.