Ferenczy A, Behelak Y, Haber G, Wright T C, Richart R M
Department of Pathology, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada.
J Gynecol Surg. 1995 Spring;11(1):41-50. doi: 10.1089/gyn.1995.11.41.
Our objective was to assess the technical characteristics, side effects, complications, and effectiveness of electrosurgery vs continuous wave CO2 laser in the treatment of genital warts. This open clinical trial was made up of 208 evaluable patients (135 women and 73 men) with vaginal and external anogenital condylomas. To avoid selection bias, in each patient half of the lesions measuring 2 cm2 or greater total linear area were treated with loop electroexcision and ball electrofulguration, and the other half were treated with CO2 laser excision and vaporization in a continuous wave mode spot welding. All patients were followed for at least 6 months (maximum 18 months, mean 8 months) after the last treatment received. The average operative time was 6 min for electrosurgery and 8 min for laser. Healing was completed in 95% of patients with a lesional area of 5 cm2 or less and 100% of patients with 5 cm2 or larger by the third and sixth postoperative week, respectively. Severe discomfort occurred in 12% of patients, and 4% of patients developed delayed complications, including vitiligo and scarring, irrespective of treatment modalities used. Complete clearance of warts in women and men after a single (51% and 38%) and multiple (75% and 64%) treatments were similar in areas treated with electrosurgery and CO2 laser. Electrosurgery appears to be as effective as continuous wave CO2 laser for treating vaginal and external anogenital condylomas, particularly those limited to a 5 cm2 or less area.
我们的目的是评估电外科手术与连续波二氧化碳激光治疗尖锐湿疣的技术特点、副作用、并发症及有效性。这项开放性临床试验纳入了208例可评估患者（135例女性和73例男性），均患有阴道及外生殖器尖锐湿疣。为避免选择偏倚，对于每位患者，将总面积达2 cm2或更大的线性面积的一半疣体采用环形电切术和球形电灼术治疗，另一半疣体采用连续波模式点焊的二氧化碳激光切除术和汽化术治疗。所有患者在接受最后一次治疗后至少随访6个月（最长18个月，平均8个月）。电外科手术的平均手术时间为6分钟，激光治疗为8分钟。病变面积5 cm2或更小的患者中，95%在术后第三周愈合，病变面积5 cm2或更大的患者中，100%在术后第六周愈合。12%的患者出现严重不适，4%的患者出现延迟并发症，包括白癜风和瘢痕形成，无论采用何种治疗方式。在接受电外科手术和二氧化碳激光治疗的区域，单次（女性51%、男性38%）和多次（女性75%、男性64%）治疗后尖锐湿疣完全清除的情况相似。电外科手术在治疗阴道及外生殖器尖锐湿疣方面似乎与连续波二氧化碳激光同样有效，尤其是对于那些局限于5 cm2或更小面积的疣体。
