The advantages of CO2 laser use in treatment of cervix dysplasia

Abstract

We use two kinds of laser treatment, namely, laser vaporisation and laser excision conisation. Laser vaporisation is a widely used method of localised ablative treatment based on both histologically confirmed cervical intraepithelial neoplasia and clear colposcopic visualisation of the upper limit of the lesion. Laser excision conisation is performed, if cervical intraepithelial neoplasia reaches the endocervix, being out of colposcopic view, and the squamocolumnar junction is localised in the endocervical canal. 116 patients with cervical intraepithelial neoplasia were treated with the CO2 laser. 81 (70%) were subjected to laser vaporisation, 35 (30%) to laser excision conisation. Intraoperative bleeding was rarely seen. After laser vaporisation, no complications were observed, but laser excision conisation complications occurred in one patient who developed postoperative cervical stenosis, and in another patient, who had postoperative bleeding requiring surgical examination. Follow-up with colposcopy and cytologic smears was carried out every 6 months. Recurrence of disease 6 months or later after laser treatment was seen in 6 patients (7.4%) after laser vaporisation and in 2 patients (5.7%) after laser excision conisation. This report shows the advantages of the carbon dioxide laser in comparison to cold knife conisation in the treatment of cervical intraepithelial neoplasia.