[COLPOSCOPY ASSISTED LASER MICROSURGERY FOR CERVICAL PATHOLOGY].

AIM: A short presentation of the method--laser microsurgery and analysis of the achieved results.

MATERIALS AND METHODS: 631 laser procedures were done for 3 years (2008- 2011) at Tokuda hospital outpatient department. These procedures were divided as follows: 607 laser vaporizations and 24 laser conisations. Indications for vaporizations were: CINI-114 patients, CIN II--26 patients, CIN III (without invasion of the cervical os) -26 patients and 422 patients were done laser vaporization for different reasons-papiloma, leucoplakia, atypical vessels and so on.... Indications for laser conisations were: CIN I- 2 patients, CIN II- 2 patients, CIN III- 12 patients (all dysplasies entered the cervical os). After laser conisation, we take a sample of the cutting line in cervical channel, which in fact substitutes the curettage of the last one during standard cold knife conisation. Technically the laser procedures were done by CO2 laser LUMENIS, directed by, mounted on binocular colposcop Karl Zeiss and standard gas evacuation system, assembled with vaginal speculum. All patient were followed up for the period of 1 year-colposcopic exam and cytology (PAP smear). All procedures were recorded and the data base that is included in these records are: diagnosis, colposcopic picture and type of laser procedure.

RESULTS: The follow up of 422 patients that underwent laser vaporizations for minor lesions show no complications and recidiv. Out of 185 patients vaporazied for CIN I- CIN III, only in one was found cervical dysplasia entering the CC during the follow up, which made it necessary to go for laser conisation (no further problems detected after it). 2 out of 24 laser conisations went under LHT because of dysplasia in the cutting edge (these patients were with finished reproduction plans) and one patient went for laser re-conisation(has no children)for the same reason.

COMPLICATIONS: In 2 patients there was a heavy bleeding, which started within 6 hours after the procedure. Laser coagulation was done, vaginal tamponade was placed for 24 hours and there was no bleeding after their removal.

CONCLUSIONS: The results that we achieved with laser microsurgery, as also the results from other European centers allows us to recommend the laser vaporization/conisation as a save and sure method for the treatment of cervical dysplasias.