Matsuo N, Iwasaka T, Hayashi Y, Hachisuga T, Ohkuma Y, Fukuda K, Sugimori H
Department of Obstetrics and Gynecology, Saga Medical School.
Nihon Sanka Fujinka Gakkai Zasshi. 1990 Jan;42(1):93-8.
One hundred twenty patients with cervical neoplasia were treated by conization, 78 with a carbon dioxide laser and 42 with a cold knife. Bleeding during the conization was 82.5 +/- 91.4 ml with the laser and 117.3 +/- 82.6 ml with the cold knife. The time required for the operation was 55.0 +/- 16.7 min and 37.7 +/- 10.2 min, respectively. With the aid of a local injection of epinephrine, peroperative bleeding was much less pronounced in the laser group (25.4 +/- 39.5 ml) and the time required for the operation was further shortened to 36.4 +/- 15.0 min. Six patients treated with the cold knife (14.3%) suffered postoperative hemorrhage requiring hemostasis, but only one in the laser series (1.3%). Forty-nine patients of 78 treated with the laser and 15 of 42 treated with the cold knife were subjected to conservative therapy. All of them were followed up by cytology, colposcopy and histology, and there was no failure or recurrence at either 8 weeks and 1 year after the operation. Unsatisfactory colposcopic findings developed in 9 patients (18.4%) in the laser group compared with 11 patients (73.3%) in the cold knife group. Specimens obtained after laser conization were satisfactory for use in histopathological evaluation. Conization with a carbon dioxide laser appears to be an acceptable procedure as a diagnostic method and conservative therapy for cervical neoplasia.
120例宫颈肿瘤患者接受了锥切术，其中78例采用二氧化碳激光治疗，42例采用冷刀治疗。激光锥切术中出血量为82.5±91.4毫升，冷刀锥切术中出血量为117.3±82.6毫升。手术所需时间分别为55.0±16.7分钟和37.7±10.2分钟。借助局部注射肾上腺素，激光组术中出血明显减少（25.4±39.5毫升），手术所需时间进一步缩短至36.4±15.0分钟。6例冷刀治疗患者（14.3%）术后出血需要止血，而激光组仅1例（1.3%）。激光治疗的78例患者中有49例和冷刀治疗的42例患者中有15例接受了保守治疗。所有患者均通过细胞学、阴道镜检查和组织学进行随访，术后8周和1年时均未出现失败或复发情况。激光组9例患者（18.4%）出现不满意的阴道镜检查结果，而冷刀组为11例患者（73.3%）。激光锥切术后获得的标本可用于组织病理学评估。二氧化碳激光锥切术作为宫颈肿瘤的诊断方法和保守治疗似乎是一种可接受的手术。
