The past several years have seen the general adoption of colposcopy as part of the routine evaluation of abnormal cervical cytology. The indications for cone biopsy are, therefore, more limited now than in the past. This procedure is still
mandatory to
evaluate CIN in women with a transformation zone that is not completely visible coloposcopically. It is also indicated for extensive lesions of CIS and in situations in which the severity of the cytology is not explained by colposcopic
examination
and
biopsy.
In the face of the changing role of cone biopsy, we have reviewed the clinical material to evaluate the efficacy of conization. Histopathologic findings of 125 conization cases were compared to the cytology, multiple punch biopsy, colpodirected
punch
biopsy and postcone hysterectomy findings. Forty seven patients had been managed by multiple punch biopsy and 78 patients, by colpodirected punch biopsy before conization from January, 1981 to December, 1991 at the Gynecologic Department of
Chonbuk
University Hospital.
@ES The results were summarized as follows:
@EN 1. The rate of agreement and underdiagnosis of 4-qudrant punch biopsy were 65.9%, 34.1% and those of colpodirected punch biopsy were 70.6%, 29.4% respectively to the result of conization.
2. The frequency of residual lesions in the postcone hysterectomy specimens was 64.5% in precolposcopic group, 40% in postcolposcopic group, and 48.9% in total.
3. Overall complications of conization was 9.6%, of which 4.8% was bleeding requiring resuture or operation.
4. According to conization-hysterectomy time interval, frequency of postoperative morbidity was 46.2% between 3 days and 6 weeks, 10.3% before 48 hours and after 6 weeks.
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