Jobson V W, Homesley H D
Obstet Gynecol. 1983 Jul;62(1):90-3.
The carbon dioxide laser was used to treat vaginal intraepithelial neoplasia in 24 patients. Initially, partial or complete ablation of vaginal epithelium was performed, the extent of the procedure depending upon the distribution of disease. Later in the series complete ablation was performed routinely because of recurrences among patients treated with only partial ablation. Fifteen patients had severe dysplasia or carcinoma in situ (vaginal intraepithelial neoplasia III), and nine had moderate dysplasia (vaginal intraepithelial neoplasia II). Of the 24 patients, 20 had satisfactory removal of vaginal intraepithelial neoplasia after a single operation. Four patients with vaginal intraepithelial neoplasia III who underwent partial vaginal epithelial ablation had persistence of abnormal tissue detected within six months of treatment. These patients were re-treated successfully with the laser. Average length of hospitalization for vaginal epithelial ablation with the carbon dioxide laser was two days. Excellent postoperative healing occurred and all patients have resumed their pretreatment sexual pattern. Follow-up ranges from six to 27 months, with an average follow-up of 15 months. The carbon dioxide laser can be used cost-effectively to remove vaginal intraepithelial neoplasia.
二氧化碳激光被用于治疗24例阴道上皮内瘤变患者。最初，对阴道上皮进行部分或完全切除，手术范围取决于病变的分布情况。在该系列治疗后期，由于仅接受部分切除的患者出现复发，因此常规进行完全切除。15例患者患有重度发育异常或原位癌（阴道上皮内瘤变III级），9例患有中度发育异常（阴道上皮内瘤变II级）。24例患者中，20例在单次手术后阴道上皮内瘤变得到满意切除。4例接受部分阴道上皮切除的阴道上皮内瘤变III级患者在治疗后6个月内检测到异常组织持续存在。这些患者再次接受激光治疗成功。二氧化碳激光进行阴道上皮切除的平均住院时间为两天。术后愈合良好，所有患者都恢复了治疗前的性行为模式。随访时间为6至27个月，平均随访时间为15个月。二氧化碳激光可经济有效地用于切除阴道上皮内瘤变。
