Bostofte E, Berget A, Falck Larsen J, Hjortkjaer Pedersen P, Rank F
Acta Obstet Gynecol Scand. 1986;65(3):199-202. doi: 10.3109/00016348609155170.
In a randomized trial concerning 123 women with CIN, 59 were treated with laser conization under colposcope without further hemostatic remedy and 64 with cold knife conization guided by Schiller's iodine dyeing supported by side sutures, vaginal packing and postoperative oral administration of tranexam acid. Follow-up with colposcopy and cytology was done 3 and 12 weeks post-conization and then every 6 months. The average follow-up period was 36 months (28-48). Peroperative bleeding was rather less pronounced in the laser group. Postoperatively, however, bleeding requiring treatment was significantly less common in the laser group (5%) than in the cold knife group (17%). The recurrence rate of CIN was 7% in the laser group and 10% in the knife group. Stenosis of the cervical canal developed in 7% of the patients in the laser group and in 3.5% in the knife group. After 12 weeks the squamocolumnar junction was visible in its full extent in 66% of the laser treated patients compared with 38% of the cold knife treated patients. It is concluded that laser conization is a safe procedure even without hemostatic procedures other than the coagulation abilities of the laser beam itself, as used in this work.
在一项针对123例宫颈上皮内瘤变（CIN）女性患者的随机试验中，59例患者接受了阴道镜下激光锥切术，未采取进一步的止血措施；64例患者接受了在席勒碘染色引导下的冷刀锥切术，并辅以侧方缝合、阴道填塞及术后口服氨甲环酸。锥切术后3周和12周进行阴道镜检查和细胞学检查随访，之后每6个月随访一次。平均随访期为36个月（28 - 48个月）。激光组术中出血情况相对不那么明显。然而，术后需要治疗的出血在激光组（5%）明显比冷刀组（17%）少见。CIN的复发率在激光组为7%，在冷刀组为10%。激光组7%的患者出现宫颈管狭窄，冷刀组为3.5%。12周后，66%接受激光治疗的患者鳞柱交界完全可见，而接受冷刀治疗的患者这一比例为38%。结论是，如本研究中所采用的，即使不采用除激光束自身凝血能力之外的止血措施，激光锥切术也是一种安全的手术方法。
