Management of adenocarcinoma in situ of the uterine cervix: a comparison of loop electrosurgical excision procedure and cold knife conization
. J Low Genit Tract Dis.
It may be considered as a suitable alternative to cold knife conization
or hysterectomy for younger females who are yet to complete their families.
The physician decided to do a cold knife conization
to rule out a more severe lesion.
Ademas, necesita tambien de analisis con su prueba de referencia, la biopsia de cuello uterino, y los especimenes quirurgicos de biopsias en cono del cuello uterino: CKC (cold knife conization
), LETZ(loop excision of the transformation zone) o LEEP (loop electrical excision procedure).
(1) TABLE 2 Obstetrical outcomes for CIN 2 and 3 treatment options RELATIVE RISK TREATMENT TYPE OBSTETRICAL OUTCOME (95% CI) Cold knife conization
Preterm delivery 2.59 (1.80-3.72) Low birth weight 2.53 (1.19-5.36) Cesarean delivery 3.17 (1.07-9.40) Laser conization Preterm delivery 1.71 (0.93-3.14) LEEP Preterm delivery 1.70 (1.24-2.35) Low birth weight 1.82 (1.09-3.06) Preterm premature rupture 2.69 (1.62-4.46) of membranes Source: Kyrgiou et al, Lancet 2006.
Excision methods include cold knife conization
(CKC), loop electrosurgical excision procedure (LEEP), or laser.
A comparison between loop electrosurgical excision procedure and cold knife conization
for treatment of cervical dysplasia: residual disease in a subsequent hysterectomy specimen.
Referral for cold knife conization
was limited to patients with glandular atypia on biopsy or endocervical curretage, or colposcopic impression of glandualr atypia.
Some have advocated for less radical surgery, such as simple trachelectomy or large cold knife conization
, as the risk of parametrial extension in these patients is low (Gynecol Oncol.
Based on prior studies of pregnant patients who had undergone cold knife conization
, complications do not occur until there is considerably greater cervical tissue excision than that which occurs in clectrosurgical loop excisions.
One study found microfibrillar collagen (MC) use during cold knife conization
resulted in nonsignificant reduction in operative time and similar hemostatic results compared to Sturmdorf suture (Obstet.
A randomized trial comparing two methods of cold knife conization
with laser surgery.