Laser or cryotherapy for cervical intraepithelial neoplasia: A randomized study to compare efficacy and side effects

Kwikkel, H.J.; Helmerhorst, Th.J.M.; Bezemer, P.D.; Quaak, Mirjam; Stolk, J.

doi:10.1016/0090-8258(85)90003-4

Cited by 45 publications

(32 citation statements)

References 23 publications

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“…[13][14][15] Results from Guijon suggest that older women were less likely to fail therapy, although the difference was not statistically significant. 16 In present study, most of the patients were multiparous.…”

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confidence: 89%

Cryotherapy for cervical lesions: efficacy and patient satisfaction

Katakdhond

Samant

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Vaginal discharge is a distressing commonplace gynecological condition seen in all age groups albeit from different causes. This study evaluates the outcome of cryotherapy on benign cervical lesions over a period of 2 years in a tertiary care centre. Efficacy of cryotherapy in making patient symptom free. Efficacy of cryocauterization in healing the cervical lesion.Methods: This is prospective observational study of 30 women of reproductive age group attending outpatient department for complaint of vaginal discharge. Cervical cytology was performed for all women and out of the women advised cryotherapy, those fitting inclusion criteria and consenting for study were enrolled. Their findings and investigations were noted. After they underwent cauterization, they were followed for period of 3 months. Findings, complications and level of satisfaction were noted down.Results: Healing of cervical lesion was complete in 96% women at the end of 12 weeks. There was 1 failure of therapy among sample size of 30. Satisfaction rate was high.Conclusions: Cervical cryocauterization is a cheap, effective and simple procedure for treatment of cervical lesions. There are few complications and patient satisfaction is high. It is an easily accessible and safe procedure and helps preserve fertility of women at the same time addressing the vaginal discharge.

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confidence: 89%

Cryotherapy for cervical lesions: efficacy and patient satisfaction

Katakdhond

Samant

2017

Int J Reprod Contracept Obstet Gynecol

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“…Peri-operative severe bleeding: Meta-analysis of two RCTs (Berget 1987;Kwikkel 1985), assessing 305 participants, showed no statistically significant difference in the risk of perioperative severe bleeding in women who received either laser ablation or cryotherapy (RR 5.83,95% CI 0.71 to 47.96). The percentage of the variability in effect estimates that was due to heterogeneity rather than by chance was not important (I 2 = 0%).…”

Section: Laser Ablation Compared With Cryotherapymentioning

confidence: 99%

“…to cryotherapy (Berget 1987;Jobson 1984;Kirwan 1985;Kwikkel 1985;Mitchell 1998;Townsend 1983), knife conisations (Bostofte 1986;Kristensen 1990;Larsson 1982;Mathevet 1994), LLETZ using either conisation techniques (Crompton 1994;Mathevet 1994;Oyesanya 1993;Paraskevaidis 1994;Santos 1996;Vejerslev 1999) or laser ablation (Alvarez 1994;Dey 2002;Mitchell 1998) and the different laser techniques (ablation versus conisation (Partington 1989).…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Eight trials included the use of cold coagulation as a technique, comparing this to LLETZ (Chirenje 2001) or laser surgical techniques (Berget 1987;Jobson 1984;Kirwan 1985;Kwikkel 1985;Mitchell 1998;Townsend 1983). A further trial compared differing types of cryotherapy, single versus double freeze techniques (Schantz 1984).…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Residual disease: Meta-analysis of six RCTs (Berget 1987;Jobson 1984;Kirwan 1985;Kwikkel 1985;Mitchell 1998;Townsend 1983), assessing 935 participants, found no significant difference between the two treatments (RR 1.13, 95% CI 0.73 to 1.76). The percentage of the variability in effect estimates that was due to heterogeneity rather than sampling error (chance) may represent moderate heterogeneity (I 2 = 35%).…”

Section: Laser Ablation Compared With Cryotherapymentioning

confidence: 99%

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Surgery for cervical intraepithelial neoplasia

Martin-Hirsch

Paraskevaidis

Kitchener

1999

Cochrane Database of Systematic Reviews

155

171

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Surgery for cervical intraepithelial neoplasia

Martin-Hirsch

Paraskevaidis

Bryant

et al. 2010

Cochrane Database of Systematic Reviews

120

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Background Cervical intraepithelial neoplasia (CIN) is the most common pre-malignant lesion. Atypical squamous changes occur in the transformation zone of the cervix with mild, moderate or severe changes described by their depth (CIN 1, 2 or 3). Cervical intraepithelial neoplasia is treated by local ablation or lower morbidity excision techniques. Choice of treatment depends on the grade and extent of the disease. Objectives To assess the effectiveness and safety of alternative surgical treatments for CIN. Search methods We searched the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE and EMBASE (up to April 2009). We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of included studies. Selection criteria Randomised controlled trials (RCTs) of alternative surgical treatments in women with cervical intraepithelial neoplasia. Data collection and analysis Two review authors independently abstracted data and assessed risks of bias. Risk ratios that compared residual disease after the follow-up examination and adverse events in women who received one of either laser ablation, laser conisation, large loop excision of the transformation zone (LLETZ), knife conisation or cryotherapy were pooled in random-effects model meta-analyses. Main results Twenty-nine trials were included. Seven surgical techniques were tested in various comparisons. No significant differences in treatment failures were demonstrated in terms of persistent disease after treatment. Large loop excision of the transformation zone appeared to provide the most reliable specimens for histology with the least morbidity. Morbidity was lower than with laser conisation, although the trials did not provide data for every outcome measure. There were not enough data to assess the effect on morbidity when compared with laser ablation. Authors’ conclusions The evidence suggests that there is no obvious superior surgical technique for treating cervical intraepithelial neoplasia in terms of treatment failures or operative morbidity.

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Laser or cryotherapy for cervical intraepithelial neoplasia: A randomized study to compare efficacy and side effects

Cited by 45 publications

References 23 publications

Cryotherapy for cervical lesions: efficacy and patient satisfaction

Cryotherapy for cervical lesions: efficacy and patient satisfaction

Surgery for cervical intraepithelial neoplasia

Surgery for cervical intraepithelial neoplasia

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