Comparison of the hemostatic suture with non-suture cold-knife conization methods for cervical surgery

Objective: The primary purpose of this study is to compare the suture with non-suture cold-knife after conization methods. Method: The study included 172 women who underwent the cold-knife conization.. In the first group, patients underwent cold-knife conization without sutures, and in the second group, patients underwent cold-knife conization with suture. The essential variables of this study include blood loss, duration of operation, number of pregnancies, type of childbirth, and age of the patient. The results are calculated based on t-test, Fisher exact test, chi-square, and nonparametric Mann-Whitney tests. Result: There was no significant difference between the variables studied, including blood loss (p-value = 0.185). The only significant difference was in the duration of operation (P-value = 0.000). Conclusion: Our findings showed that there was no significant difference between the amount of blood loss between the sutured and non-sutured groups. These results also showed that the operation duration was significantly reduced. This result was excepted since there was no need for suturing, and the other stages of the procedure were the same throughout the cold knife canonization in both groups. Due to the shorter operation duration, no difference in the amount of postoperative bleeding, and the specific risks of suture, it is suggested to use a non-suture technique for cold-knife conization.

Keywords:

Cervical Intraepithelial Neoplasia, CIN Cold-knife Conization, Cervical Surgery,

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Mathevet P, Dargent D, Roy M, Beau G. A randomized prospective study comparing three techniques of conization: cold knife, laser, and LEEP. Gynecol Oncol 1994; 54: 175-9.
Larsson GÖ, Gullberg B, Grundsell HA. A comparison of complications of laser and cold knife conization. Obstetr Gynecol 1983; 62: 213-7.
Mathevet P, Chemali E, Roy M, Dargent D. Long-term outcome of a randomized study comparing three techniques of conization: cold knife, laser, and LEEP. Eur J Obstetr Gynecol Reproduct Biol 2003; 106: 214-8.
Duggan BD, Felix JC, Muderspach LI, et al. Cold-knife conization versus conization by the loop electrosurgical excision procedure: a randomized, prospective study. Am J Obstetr Gynecol 1999; 180: 276-82.
Reich O, Lahousen M, Pickel H, Tamussino K, Winter R. Cervical intraepithelial neoplasia III: long-term follow-up after cold-knife conization with involved margins. Obstetr Gynecol 2002; 99: 193-6.
Reich O, Pickel H, Lahousen M, Tamussino K, Winter R. Cervical intraepithelial neoplasia III: long-term outcome after cold-knife conization with clear margins. Obstetr Gynecol 2001; 97: 428-30.
Larsson G, Alm P, Grundsell H. Laser conization versus cold knife conization. Surg Gynecol Obstetr 1982; 154: 59-61.
Huang LW, Hwang JL. A comparison between loop electrosurgical excision procedure and cold knife conization for treatment of cervical dysplasia: residual disease in a subsequent hysterectomy specimen. Gynecol Oncol 1999; 73: 12-5.
Naumann RW, Bell MC, Alvarez RD, et al. LLETZ is an acceptable alternative to diagnostic cold-knife conization. Gynecol Oncol 1994; 55: 224-8.
Giacalone PL, Laffargue F, Aligier N, Roger P, Combecal J, Daures JP. Randomized study comparing two techniques of conization: cold knife versus loop excision. Gynecol Oncol 1999; 75: 356-60.
Girardi F, Heydarfadai M, Koroschetz F, Pickel H, Winter R. Cold-knife conization versus loop excision: histopathologic and clinical results of a randomized trial. Gynecol Oncol 1994; 55: 368-70.
Oyesanya OA, Amerasinghe C, Manning ED. A comparison between loop diathermy conization and cold-knife conization for management of cervical dysplasia associated with unsatisfactory colposcopy. Gynecol Oncol 1993; 50: 84-8.
Klaritsch P, Reich O, Giuliani A, Tamussino K, Haas J, Winter R. Delivery outcome after cold-knife conization of the uterine cervix. Gynecol Oncol 2006; 103: 604-7.
Saidi MH, Setzler Jr FD, Sadler RK, Farhart SA, Akright BD. Comparison of office loop electrosurgical conization and cold knife conization. J Am Assoc Gynecol Laparoscopists 1994; 1: 135-9.
Mohamed-Noor K, Quinn MA, Tan J. Outcomes after cervical cold knife conization with complete and incomplete excision of abnormal epithelium: a review of 699 cases. Gynecol Oncol 1997; 67: 34-8.
Demeter A, Sziller I, Csapo Z, Szánthó A, Papp Z. Outcome of pregnancies after cold-knife conization of the uterine cervix during pregnancy. Eur J Gynecol Oncol 2002; 23: 207-10.
Hillemanns P, Kimmig R, Dannecker C, et al. LEEP versus cold knife conization for treatment of cervical intraepithelial neoplasias. Zentralblatt fur Gynakologie 2000; 122: 35-42.
Tangtrakul S, Srisupundit S, Linasmita V, et al. A randomized study comparing suture with non-suture cold‐knife conization. J Obstetr Gynaecol 1995; 21: 587-91.
Gilbert L, Saunders NJ, Stringer R, Sharp F. Hemostasis and cold knife cone biopsy: a prospective randomized trial comparing a suture versus non-suture technique. Obstetr Gynecol 1989;74: 640-3.
Kamat AA, Kramer P, Soisson AP. Superiority of electrocautery over the suture method for achieving cervical cone bed hemostasis. Obstetr Gynecol 2003; 102: 726-30.
Dane C, Dane B, Cetin A, Erginbas M. Haemostasis after cold‐knife conisation: a randomised prospective trial comparing cerclage suture versus electro‐cauterisation. Australian and New Zealand J Obstetr Gynaecol 2008; 48: 343-7.
Bueno LR, Binda M, Monego H, et al. Randomized clinical trial comparing cold knife conization of the cervix with and without lateral hemostatic sutures. Int J Surg 2015; 18: 224-9.