| The Efficacy of Combination of Cold-Knife Conization and Cold-Coagulation for Diagnosis and Treatment of the Cervical Intraepithelial Neoplasia. |
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Kyung Hwa Yi, Young Sook Jeon, Byoung Taek Kim, Jong Hoon Kim, Byoung Gie Kim, Sang Yoon Park, Eui Don Lee, Kyung Hee Lee, Kee Bock Park |
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Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Seoul, Korea. |
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| Abstract |
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This study was performed to demonstrate the efficacy of combination of cold-knife conization and cold-coagulation for the treatment of cervical intraepithelial neoplasia(CIN). In addition, the accuracy of the colposcopic biopsy and Pap smear compare to conization was determined. Cold-coagulation was performed simultaneously in 151 patients after cold-knife conization for diagnosis and treatment of CIN from Jan. 1995 to Dec. 1996. Medical records and pathologic slides of those patients were reviewed. Histologic comparison between the Pap smear and conization specimens showed agreement with 70 % within one grade difference ; Histologic comparison between the colpodirected punch biopsy and conization specimens showed agreement with 80 %. The margin involvement of conization was seen in 35 patients(23 %). There was a tendency of increasing rate of positive cone margin with grade of the lesion : 14 %(1/7) in CIN 1, 20 %(2/10) in CIN 2, 35 %(31/88) in CIN 3, and 33 %(1/3) in microinvasive cervical cancer. Among these 35 patients, 11 patients underwent hysterectomy and showed residual disease in 4 patients(36 %). Recurrence of CIN was found in 4 patients(16 %) with positive cone margin and 1 patient(0.9 %) with negative cone margin. Bleeding was observed in 13 patients(9 %). Two patients underwent hysterectomy because of severe bleeding. These results suggest that cold-knife conization with cold-coagulation is an effective procedure to reduce recurrence rate of the patients with CIN regardless of status of cone margin and to reduce the severity of bleeding after conization. |
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