Diakomanolis E, Rodolakis A, Sakellaropoulos G, Kalpaktsoglou K, Aravantinos D
1st Department of Obstetrics and Gynecology, Athens University, Greece.
Eur J Gynaecol Oncol. 1996;17(5):389-92.
Carbon Dioxide Laser ablation therapy was originally offered to 25 women with Vaginal Intraepithelial Neoplasia (VAIN). The disease was primary in 12 and secondary after a previous hysterectomy in 13 cases. Treatment was accomplished under local anesthesia in 22 cases and was well-tolerated by all patients. The age of the patients ranged from 19 to 68 with a mean age of 44 years. All women were followed-up by cytology and colposcopy within a time period of 35 to 82 months (mean 49 months). Eight patients relapsed resulting in a failure rate of 32%. A second Laser CO2 treatment was offered to these patients with a final cure rate of 84% (21/25). The four cases in which the disease reappeared, after the 2nd treatment, were managed by upper colpectomy (3 cases) and follow-up (1 case). Laser CO2 ablation is an acceptable treatment modality for VAIN considering the promising cure rates and the preservation of the anatomic integrity of the vagina. Close colposcopic follow-up of these patients is necessary for early detection of disease relapses.
二氧化碳激光消融疗法最初应用于25例阴道上皮内瘤变（VAIN）患者。其中12例为原发性疾病，13例为既往子宫切除术后继发性疾病。22例患者在局部麻醉下完成治疗，所有患者耐受性良好。患者年龄在19岁至68岁之间，平均年龄44岁。所有女性在35至82个月（平均49个月）的时间内接受了细胞学和阴道镜检查随访。8例患者复发，失败率为32%。对这些患者进行了第二次二氧化碳激光治疗，最终治愈率为84%（21/25）。第二次治疗后疾病复发的4例患者，3例行高位阴道切除术，1例进行随访。考虑到有前景的治愈率以及对阴道解剖完整性的保留，二氧化碳激光消融是一种可接受的VAIN治疗方式。对这些患者进行密切的阴道镜随访对于早期发现疾病复发是必要的。
