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COMPARISON BETWEEN LOOP DIATHERMY CONIZATION AND COLD KNIFE CONIZATION AT SRINAGARIND HOSPITAL

การศึกษาเปรียบเทียบระหว่าง Loop Diathermy Conization และ Cold Conization ในโรงพยาบาลศรีนครินทร์

Prasit Pengsaa 1, Banchong Udomthavornsuk, 2, Somporn Pothinam 3, Pissamai Yuenyao 4

1. Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand., MD,
2. Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand., MD,
3. Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand., MD,
4. Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand., MD,

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OBJECTIVE :
 To compare loop diathermy conization (LDC) with the conventional coke knife conization in term of diagnostic quality of the specimens, cure rate, perioperative and postoperative hemorrhage, operation time and costs of the procedures.
STUDY DESIGN :
 A retrospective study was carried out in 104 patients with abnormal cervical cytology or cervical lesions suspicious of carcinoma of the cervix. Cold knife conization were done in 59 patients by staffs and residents of the  Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. The diathermy loop were done by the author (PP) and the instrument used was the insulated shaft attached to an insulated transverse arm with 0.2 mm.-diameter, 20 mm length, 15 mm width stainless steel wire. The diathermy power was the Ellman Surgitron FFPF radiosurgical instrument with blended mode and 35-40 W. The procedure performed under local anesthesia in the operative treatre as outpatient visit. The ball-point cautery and/or Monsel solution was used for hemosthesis. The cold knife conization were done by staffs and residents of the Department of Obstetrics and Gynecology under spinal or general anesthesia.
RESULTS :
 The significant decreased were observed in the loop diathermy group than of the cold knife conization patients in the operation time, perioperative and postoperative hemorrhage, days of hospitalization and the total costs of the procedures. The dimensions of the specimens from cold knife conization were significantly greater than of loop diathermy conization. There was no different in the rate of detection of abnormal cervical pathology and quality of special mens as well as the success rate of treatment at 6 months follow-up.
CONCLUSION :
 Loop diathermy conization is a reliable, welltolerated and cost-effective technique for the management of abnormal cervical cytology. This outpatient procedure is recommended for the replacement of the conventional cold knife conization in community hospitals in developing countries like Thailand.
Key word : loop diathermy, cone, cervix, cytology.
*Presented at the 11th  Asia Pacific Cancer Conference, 18 November, 1993, Central Plaza, Bangkok, Thailand.
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