Laser Conization of the Uterine Cervix

In: Advances in Nd:YAG Laser Surgery · 1988 · pp. 183–191 · doi:10.1007/978-1-4612-3728-0_26 · W321220907
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This paper discusses the controversy surrounding optimal treatment for cervical intraepithelial neoplasia and evaluates the CO2 laser conization method, finding it has serious deficiencies.

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This chapter discusses controversy over optimal treatment of intraepithelial cervical cancer (carcinoma in situ/CIS) and compares historical reliance on hysterectomy versus conservative approaches such as conization or destruction of the cervix. It focuses on the use of focused CO2 laser conization to excise selected cervical tissue so that histologic findings of the resected cone can be evaluated, while noting that the method also has serious deficiencies. The major limitation explicitly highlighted is that earlier conservative treatments were associated with reported recurrence, motivating continued debate about optimum therapy. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

The optimum treatment for intraepitheial cervical cancer (carcinoma in situ, CIS) has been the subject of much controversy. For many years hysterectomy was the recommended therapy because a rather high incidence of recurrence of carcinoma was reported after conservative treatments such as conization or destruction of the uterine cervix.1–3 Recently, focused CO2 laser conization, which excises selected cervical tissue, enabled us to evaluate the histologic findings of the resected cone.4,5 But we found that this method also has some serious deficiencies. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

Kirwan H, Smith IR, Naftalin NJ: A study of cryosurgery and the CO, laser in treatment of carcinoma in situ (CIN III) of the uterine cervix. Gynecol Oncol 22: 195–220, 1985. Nagell JR: Diagnostic and therapeutic efficacy of cervical conization. Am J Obstet Gynecol 124: 134–139, 1976. Ahlgrem M: Conization and treatment of carcinoma in situ of the uterine cervix. Obstet Gynecol 46: 135–140, 1975. Meandzija MP, Locher G, Jackson JD: CO, laser conization versus conventional conization: A clinico-pathological appraisal. Lasers Surg Med 4: 139–144, 1984. Grundsell H., Alm P, Larsson G: Cure rates after laser conization for early cervical neoplasia. Ann Chir Gynecol 72: 218–222, 1983. Dakiuzono N, Joffe, SN: Artificial sapphire for contact photocoagulation and tissue vaporization with the Nd:YAG laser. Med Instrum 19: 173–178, 1985. Totani R, Korasawa T, Suzuoki, Y: Application of newly-developed contact type surgical rod for Nd:YAG laser conization of uterine cervix. Laser Optoelectonics in Medicine Springer-Verlag, Tokyo, 1986, pp 495–501. Japan Obstetrics and Gynecology Society. Annual Reports: Statistical Data of Cervical Cancer, 1974–1983. Scott JW, Welch WB, Blake TF: Bloodless technique of cold knife conization Am J Obstet Gynecol 79: 62 1960. Baggish MS, Dersey JH: Carbon dioxide laser for combination excisional vaporization conization. Am J Obstet Cynecol 131: 23–27 (1985). Wright VC, Davies E, Riopella MA: Laser cylindrical excision to replace conization. Am J Obstet Gynecol 150: 704–709 1984. Lobraico RV: Lasers in gynecology. Med Instrum 17: 411, 1983. Schellhans HF, Weppelmann B: The neodymium:YAG laser in the treatment of gynecologic malignancies. Lasers Surg Med 3: 225–229, 1983. Larsson G: Conization for preinvasive and early invasive carcinoma of the uterine cervix. Acta obstet Gynecol Scand Suppl 114, 1983. Editor information Editors and Affiliations Rights and permissions Copyright information © 1988 Springer-Verlag New York Inc. About this chapter Cite this chapter Totani, R., Karasawa, T., Suzuoki, Y. (1988). Laser Conization of the Uterine Cervix. In: Joffe, S.N., Oguro, Y. (eds) Advances in Nd:YAG Laser Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3728-0_26 Download citation DOI: https://doi.org/10.1007/978-1-4612-3728-0_26 Publisher Name: Springer, New York, NY Print ISBN: 978-1-4612-8322-5 Online ISBN: 978-1-4612-3728-0 eBook Packages: Springer Book Archive

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