Long Term Outcomes of Laser Conization for High Grade Cervical Intraepithelial Neoplasia in Thai Women

Wongtiraporn, Weerasak; Laiwejpithaya, Somsak; Sangkarat, Suthi; Benjapibal, Mongkol; Rattanachaiyanont, Manee; Ruengkhachorn, Irene; Chaopotong, Pattama; Laiwejpithaya, Sujera

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자료유형: 학술저널

저자정보: Wongtiraporn, Weerasak (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) Laiwejpithaya, Somsak (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) Sangkarat, Suthi (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) Benjapibal, Mongkol (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) Rattanachaiyanont, Manee (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) Ruengkhachorn, Irene (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) Chaopotong, Pattama (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) Laiwejpithaya, Sujera (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제15권 제18호

발행연도: 2014.1

수록면: 7,757 - 7,761 (5page)

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Aim: To report long term outcomes of laser conization for high grade cervical intraepithelial neoplasia (CIN) in Thai women. Materials and Methods: A retrospective cohort study was conducted in patients undergoing laser conization due to abnormal cervical cytology suggesting neoplasia during 1989 to 1994 and having follow-up data until December 2010. Conization was performed under colposcopy using a 0.5-mm $CO_2$ laser beam with power density of $18,000-20,000watts/cm^2$, and the surgical base was vaporized using a low power defocused beam. The follow-up protocol included cervical cytology and colposcopy. Long term outcome measures were failure rate (persistence and recurrence), post-conization status of transformation zone, and obstetric outcomes. Results: Of 104 patients undergoing conization, 71 had therapeutic conization for high grade CIN and were followed up for a median time of 115 (range 12-260) months. There was one case of persistent and one of recurrent disease comprising a failure rate of 2.8%. The post treatment transformation zone was well visualized in 68.3% of 63 patients with an intact uterus. Sixteen patients achieved 25 pregnancies; none had second trimester miscarriage. The obstetric outcomes were unremarkable. Conclusions: Laser conization under colposcopic visualization for the treatment of high grade CIN in Thai women has a low failure rate of 2.8%. The post-conization transformation zone could not be evaluated completely in approximately 30% of cases; therefore the follow-up protocol should include both cytology and colposcopy. Obstetric outcomes are not adversely affected by this therapeutic procedure.

#Cervical intraepithelial neoplasia #laser conization #long term outcomes #Thailand

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