Diakomanolis E, Haidopoulos D, Rodolakis A, Messaris E, Sakellaropoulos G, Calpaktsoglou C, Michalas S
1st Department of Obstetrics and Gynecology, Athens University, Alexandra Hospital, Greece.
Eur J Gynaecol Oncol. 2002;23(5):463-8.
Carbon dioxide laser (CO2) has been widely used in the past for the treatment of squamous intraepithelial lesions (SIL) of the uterine cervix. We present our 10-year experience of using this modality while evaluating its current and future use.
From 1988 to 1998, 3,078 women were treated for an intraepithelial lesion of the uterine cervix (SIL) by laser CO2 either by vaporization or conization. The procedure was performed on an outpatient basis and was well tolerated by the great majority of patients. The mean age of the women treated by vaporization was 27.5 years whereas of those managed by conization, 34.8 years.
From the 3,078 women, 750 (24.4%) underwent laser vaporization and the remaining 2,328 (75.6%), conization of the cervix. Complications were minimal and consisted of intraoperative and postoperative bleeding (0.56%), pelvic infections (0.04%) and cervical stenosis (1.1%). Mean follow-up time was 83 months (range 24-142). Relapsing disease (either persistent or recurrent) was detected in 5.6% of the vaporization and 3.9% of the conization group.
The management of SIL of the uterine cervix by laser CO2 offers excellent success rates with minor complications. The preservation of the anatomical integrity of the cervical tissue offers a better follow-up of these patients and the potential for repeat treatment. Although other treatment modalities are available, we believe that laser CO2 represents an excellent surgical tool for the management of intraepithelial lesions of the uterine cervix.
过去，二氧化碳激光（CO2）已被广泛用于治疗子宫颈鳞状上皮内病变（SIL）。我们介绍了使用这种方法的10年经验，并对其当前及未来应用进行评估。
1988年至1998年期间，3078名患有子宫颈上皮内病变（SIL）的女性接受了二氧化碳激光汽化或锥切治疗。该手术在门诊进行，绝大多数患者耐受性良好。接受汽化治疗的女性平均年龄为27.5岁，而接受锥切治疗的女性平均年龄为34.8岁。
在这3078名女性中，750名（24.4%）接受了激光汽化治疗，其余2328名（75.6%）接受了宫颈锥切术。并发症极少，包括术中及术后出血（0.56%）、盆腔感染（0.04%）和宫颈狭窄（1.1%）。平均随访时间为83个月（范围24 - 142个月）。汽化组有5.6%、锥切组有3.9%检测到疾病复发（持续或复发）。
二氧化碳激光治疗子宫颈SIL成功率高，并发症少。保留宫颈组织的解剖完整性有助于对这些患者进行更好的随访，并为重复治疗提供可能。尽管有其他治疗方式，但我们认为二氧化碳激光是治疗子宫颈上皮内病变的一种优秀手术工具。
