Keywords
low-grade intraepithelial lesion
CO₂ laser
How to Cite
Abstract
Low-grade intraepithelial lesions (LIEGL) represent a significant challenge in global gynecological health. In this context, CO₂ laser therapy has emerged as a promising therapeutic alternative. This study compared the effectiveness of CO₂ laser versus cryotherapy in the management of LIEGL among patients treated at a private center between September and December 2024. A prospective quasi-experimental observational study was conducted with a sample of 20 patients diagnosed with CIN I, randomly assigned to two groups: one treated with cryotherapy and the other with CO₂ laser. The primary outcomes were lesion regression and recurrence. The mean age was 27.5 ± 5.4 years. At three months, complete lesion regression was observed in 100% of patients treated with CO₂ laser, compared to 70% in the cryotherapy group. At six months, recurrence occurred in 10% of the laser group and 30% of the cryotherapy group, confirmed by pathological examination. No adverse effects such as bleeding, pain, or infection were reported in the laser group, while 30% of cryotherapy patients experienced leukorrhea. In conclusion, CO₂ laser therapy demonstrated a more favorable profile than cryotherapy in the treatment of CIN I, with higher remission rates, lower recurrence, and fewer complications.
References
1. Loopik D, Bentley H, Eijgenraam M, IntHout J, Bekkers R, Bentley J. The natural history of cervical intraepithelial neoplasia grades 1, 2, and 3: a systematic review and meta-analysis. Journal of Lower Genital Tract Disease, [Internet]. 2021. [Citado 27 agosto 2024]; 25(3), 221-231. Disponible en: https://journals.lww.com/jlgtd/fulltext/2021/07000/ The_Natural_History_of_Cervical_Intraepithelial.7.aspx
2. Kamariddinovna N. Evaluation of Clinical Effectiveness Of Pathogenetically Oriented Therapy For Cervical Intraepithelial Neoplasia. Journal of Pharmaceutical Negative Results, [Internet]. 2022. [Citado 27 agosto 2024]; 2665-2668. Disponible en: https://www.pnrjournal.com/index.php/home/article/view/3925
3. Ramírez E. Conocimiento y prácticas preventivas sobre cáncer de cuello uterino en mujeres de edad fértil, establecimiento de salud I-3 Florida-Chimbote, 2023. [Internet]. 2023. [Citado 7 septiembre 2024]. Disponible en: https://repositorio.uladech.edu.pe/handle/20.500.13032/36012
4. Fallani M, Penna C, Fambrini M, Marchionni M. Laser CO2 vaporization for high-grade cervical intraepithelial neoplasia: a long-term follow-up series. Gynecologic oncology, [Internet]. 2003. [Citado 27 agosto 2024]; 91(1), 130-133. Disponible en: https://www.sciencedirect.com/science/article/pii/S0090825803004402
5. . Mosseri J, Hocquemiller R, Mergui J, Uzan C, Canlorbe G. Laser conization for cervical intraepithelial neoplasia: Effectiveness and obstetric outcomes. Journal of Gynecology Obstetrics and Human Reproduction, [Internet]. 2022. [Citado 27 agosto 2024]; 51(4), 102341. Disponible en: https://www.sciencedirect.com/science/article/pii/S2468784722000332
6. Yao H, Zhang H, Pu X, Shi L, Zhang Y, Wang P, Wang X. Photodynamic therapy combined with carbon dioxide laser for low-grade vaginal intraepithelial neoplasia: a retrospective analysis. Photodiagnosis and Photodynamic Therapy, [Internet]. 2020. [Citado 27 agosto 2024]; 30, 101731. Disponible en: https://www.sciencedirect.com/science/article/pii/S1572100020300843
7. He M, Yu E, Hui S, Kung Y. Clinical outcomes of laser vaporization for vaginal intraepithelial neoplasia–A 20-year retrospective review. European Journal of Obstetrics & Gynecology and Reproductive Biology, [Internet]. 2022. [Citado 27 agosto 2024]; 277, 101-109. Disponible en: https://www.sciencedirect.com/science/article/pii/S0301211522004821
8. de Solorzano A, Rodríguez J. Laser Co2 10,600 nm en el tratamiento de lesiones cervicales por virus de papiloma humano. Revista Iberoaméricana de Láser Médico, [Internet]. 2024. [Citado 14 marzo 2025]; 4(2), 50-57. Disponible en: http://rilmed.ailmed.org/index.php/rilmed/article/view/51
9. Hoshi K, Honda S, Endo C, Sato A, Sekimoto S. Wound healing process in the portio vaginalis uteri after CO2-laser treatment. The Tohoku Journal of Experimental Medicine, [Internet]. 1993. [Citado 14 marzo 2025]; 170(3), 135-146. Disponible en: https://www.jstage.jst.go.jp/article/tjem1920/170/3/170_3_135/_article/-char/ja/
10. Santana B, Baro R, Orozco R, Arranz J. Cervical vaporization in LSIL and persistent HPV infection. Taiwanese Journal of Obstetrics and Gynecology, [Internet]. 2018. [Citado 14 marzo 2025]; 57(4), 475-478. Disponible en: https://www.sciencedirect.com/science/article/pii/S1028455918301281
11. Mitchell M, Tortolero G, Cook E, Whittaker L, Rhode H, Silva E. A Randomized Clinical Trial of Cryotherapy, Laser Vaporization, and Loop Electrosurgical Excision for Treatment of Squamous Intraepithelial Lesions of the Cervix. Obstetrics & Gynecology, [Internet]. 1998. [Citado 14 marzo 2025]; 92(5):737-744. Disponible en: https://journals.lww.com/greenjournal/abstract/1998/11000/a_randomized_ clinical_trial_of_cryotherapy,_laser.1.aspx
12. Domingo I, Coronado P, Cristóbal I, Fasero M, Rincón J, Herraiz M, Escudero M. Recidiva tras el tratamiento con láser de CO2 de las lesiones premalignas de cérvix. Toko-Gine Pract, [Internet]. 2001. [Citado 14 marzo 2025]; 60, 309-312. Disponible en: https://www.researchgate.net/profile/Pluvio-Coronado-Martin/publication/ 289363245_Recurrence_of_premalignant_lesions_of_the_uterine_cervix_after_CO2_laser_treatment/links/5ddf7861299bf10bc32bb851/Recurrence-of-premalignant-lesions-of-the-uterine-cervix-after-CO2-laser-treatment.pdf
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