A Comparison of Cold Knife, CO₂ Laser, and Electrosurgical Loop Conization in the Treatment of Cervical Intraepithelial Neoplasia

Abstract

Thirty patients with histologically confirmed high-grade squamous intraepithelial lesions (SIL) were treated by either cold knife, laser, or electrosurgical loop conization, all of which were performed under general anesthesia. The three methods were compared with respect to the immediate surgical complications, ease of performance, delayed complications, and quality of histologic specimens. The electrosurgical loop conization had decreased blood loss and reduced operative time and proved to be tissue sparing. There were no significant differences in the three groups in the persistence rates of cervical intraepithelial neoplasia (CN) after treatment. Histologic analysis revealed comparable coagulation artifact in the laser and electrosurgical loop groups that the cold knife group did not have. The endocervical component of the electrocautery showed extensive denudation and coagulation artifact that made recognition of CIN extremely difficult. We conclude that the electrocautery should be used only as an excisional method of the transformation zone for lesions well defined on the ectocervix, since it is unreliable if the lesion extends into the endocervix.

Histologic Comparison of Canine Skin Biopsies Collected Using Monopolar Electrosurgery, CO2 Laser, Radiowave Radiosurgery, Skin Biopsy Punch, and Scalpel

“…Effects of CO 2 laser on the histologic quality of excised tissues has been reported 5–14 . Margins of cervical biopsies from women collected with CO 2 laser were either difficult to interpret or were unable to be interpreted in 27% of patients 6,7 . In another study, carbonization artifact (“char”) of CO 2 laser excised biopsies resulted in specimens that were not interpretable 8 .…”

“…Previous reports have assessed the effects of CO 2 laser on the histologic quality of excised tissues from dogs and humans 5–14 . Similarly, RWRS has been reported to cause minimal tissue injury to the human uvula and soft palate, canine soft palate, human oviduct, and human skin 15–18 .…”

810nm, 980nm, 1470nm and 1950nm diode laser comparison: a preliminary “ex vivo” study on oral soft tissues

“…Average output power, frequency, energy density, pulse duration, and energy per pulse influence the laser beam interaction with the target tissue, particularly with regard to coagulation of the target tissue. Insufficient laser energy levels do not initiate tissue ablation, while excessive energy can lead to carbonization and possibly to thermal damages [15,16]. If small fragments of carbonized tissue are present on the fiber tip or on surgical anatomical surfaces, they can absorb all light wavelengths and quickly provoke overheating.…”

Ιστοπαθολογική μελέτη αξιολόγηση διοδικού laser σε βιοψίες εκτομής επιφανειακών βλαβών στοματικού βλεννογόνου

“…Χρησιμοποιείται πολύ στη θεραπεία της διαβητικής αμφιβληστροειδοπάθειας. (Lewis 1994, Yamaguchi 2012, μαστού (Dowlatshahi 2002), ουροδόχου κύστεως (Bader 2009) και γαστροοισοφαγικής συμβολής (Inue 1991, Brandt 1992.…”