Laser Diagnostic Cylindrical Excision Versus Cold-Knife Conization— A Clinical Experience of 60 Cases

Laser conical excision of the uterine cervix is a much praised procedure in current gynecological practice. From March 1986 to February 1987, cylindrical excision of the uterine cervix by carbon dioxide laser was performed for 30 patients with abnormal Papanicolau smears and colposcopic finding. During the same period, another 30 patients with the same condition, used as the control group, underwent conventional cold-knife conization. A comparison of the data of the clinical parameters between these two groups showed no significant difference. However, the comparison of the pathological parameters was as follows: specimen depth in laser cylindrical excisional specimen versus cold-knife conical specimen was 6.43 ± 2.29 mm versus 4.68 ± 2.13 mm (P < 0.001), while the lesion distance in laser cylindrical excisional specimen versus cold-knife conical specimen was 5.08 ± 2.54 mm versus 4.20 ± 1.67 mm (P < 0.01). The aforementioned figures proved that the former procedure can remove a larger volume of tissue and include more definite extension of the lesion. The potential advantages of diagnostic laser cylindrical excision in detecting a possible invasive lesion in the uterine cervix harboring cervical intraepithelial neoplasia will replace cold-knife conization.