[Five years' use of CO2 laser in the treatment of cervical lesions: 475 treated cases (mainly dysplasias and carcinomas in situ)].

The authors have used the CO2 laser for the treatment of cervical lesions since 1979. 475 cases were treated, of whom three-quarters were suffering from dysplasia or carcinoma in situ. The cases were discovered by smears from the cervix and vagina and by colposcopy and were confirmed by biopsy. The ways in which the treatment could be conducted depended on the site and not on the severity of the lesion so long as cases of micro-invasion were excluded. When the lesion was sited on the ectocervix the treatment consisted, after taking a small biopsy for histological checking, in the destruction of the lesion using a laser attached to a microscope. When the lesion was endocervical conisation had to be carried out using a laser attached to an apparatus held in the hand. Colposcopic examination carried out 15 to 20 days after treatment made it possible to discover whether the treatment had been complete or not. Recurrences are characterised by the return of colposcopic and cytological abnormalities. Sometimes these are only cytological and may occur 6 to 18 months after treatment. After 5 years the level of recurrences is remarkably low and is less than 4 per cent. Secondary complications such as haemorrhage are very rare, and the morphology of the cervix is hardly changed except in a few cases. The operator must know very well indeed how to use the colposcope to undertake such treatments successfully,