Кратък обзор на различните техники за терапия на дисплазия или казано с други думи – различните техники за конизация.

1. Обща успеваемост – General success rates

Treatment of the precursor lesions by acid, laser ablation, freezing, or loop surgical excision can adequately prevent the development of cervical malignancy. Most treatments have a 70-90% success rate.

Success was not related to severity of disease, size of lesion, or whether the endocervical canal was involved. It was related to depth of coagulation necrosis, method of applying the laser beam, and if the entire transformation zone was treated.
Louis Burke, Linda Covell, Donald Antonioli, Carbon dioxide laser therapy of cervical intraepithelial neoplasia: Factors determining success rate; Department of Obstetrics and Gynecology, Beth Israel Hospital, Harvard Medical School, Boston, MA 02215

The LEEP procedure and cone biopsy are more invasive procedures and are used mostly in only moderate or severe cases. Cryotherapy and laser treatments are less invasive than the LEEP procedure or cone biopsy. Although laser vaporization and cryotherapy are effective treatments for dysplasia, they are not suitable for invasive cancer.

The surgery can be performed under general anesthesia in the operating room with either traditional surgical instruments or with lasers. Use of laser surgery has reported success rates of up to 96% with infrequent complications.
A technique called frozen section examination (FSE) freezes the margins of the area being removed. Studies suggest that FSE allows immediate and precise evaluation of areas that may harbor invasive cancer cells, and may be an important addition to this procedure in women with high-grade CIN.
За повече информация: http://www.healthcare.com

2. Електрическа примка

LEEP (Loop ElectroSurgical Excision Procedure) или LLETZ (Large Loop Excision of the Transformation Zone). Both names refer to the removal of the outer layer of cervical cells. This process has a 95 percent success rate in removing abnormal tissue.
Excerpted from: Family Medical Guide, Fourth Edition, American Medical Association, 2004

Mayeaux and Harper (1993) reviewed separate studies of dysplasia recurrence following cryosurgery and LEEP. Success rates with no recurrence were between 90% to 98% for LEEP and 81% to 95% for cryosurgery.
Mayeaux, E. J., & Harper, M. B. (1993). Loop electrosurgical excisional procedure. The Journal of Family Practice, 36(2), 214-219.

3. Скалпена конизация.

cold-cone. Не намирам посочени конкретни проценти. На няколко места пише, че е остаряла техника и LEEP / LLETZ имат по-висок процент на успеваемост. В България все още се използва масово.