Comparison of the efficacy and complications of different surgical methods for cervical intraepithelial neoplasia.

OBJECTIVE

The aim of this was study to offer some reference for the treatment of cervical intraepithelial neoplasia (CIN) by comparing complication rates and treatment failure rates of different surgical methods of CIN.

METHODS

1,256 cases of CIN diagnosed by punch biopsy and pathological confirmation of postoperative specimens between January 2002 and June 2007 were reviewed and analyzed, in which 74 cases underwent the loop electrosurgical excision procedure (LEEP), 869 patients adopted cold knife conization (CKC), 49 patients received vaginal enlarged amputation of cervix, and 264 patients accepted extrafascial hysterectomy. The chi-square test was used to compare the rate of complication and treatment failure of different surgical methods.

RESULTS

The rates of surgical complications for LEEP, CKC, vaginal enlarged amputation of the cervix and extrafascial hysterectomy were, respectively, 8.1% (6/74) 6.2% (54/869) 6.1% (3/49) and 2.3% (8/264), but this difference was not statistically significant. The treatment failure incidences for LEEP, CKC, vaginal enlarged amputation of cervix and external fascia hysterectomy were, respectively, 4.1% (3/74), 0.2% (2/869), 0.0% (0/49) and 0.4% (1/264). When comparing among the groups, the treatment failure incidence was higher in LEEP than that in CKC (p = 0.004) and extrafascial hysterectomy (p = 0.034); there was no statistically significant difference between CKC and extrafascial hysterectomy, and no significant difference was revealed between vaginal enlarged amputation of cervix and any other group.

CONCLUSION

LEEP, CKC, vaginal enlarged amputation of cervix and extrafascial hysterectomy are all secure and effective procedures for patients with CIN, and patients can make their own individual choice depending on different conditions.