Comparison of Depth of Necrosis Using Cryotherapy by Gas and Number of Freeze Cycles. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Cremer, Miriam; Ditzian, Lauren; Winkler, Jennifer L.; Jerónimo, José; Singleton, Jered; Franco, Henry Valdivia; Maza, Mauricio; Conlisk, Elizabeth; Gage, Julia; Castle, Philip; Santos, Carlos
• Is Part Of: Journal of lower genital tract disease. Volume 19:Issue 1(2015:Jan.)
• Publication Date: 2015-01
• Subjects: Generative organs, Female -- Diseases -- Periodicals; Cervix uteri -- Diseases -- Periodicals; Generative organs -- Diseases -- Periodicals; Sexually transmitted diseases -- Periodicals; 618.1
• DOI: 10.1097/LGT.0000000000000042
• Languages: English
• ISSNs: 1089-2591

Abstract

<abstract> <title>Abstract</title> <sec> <title>Objective</title> <p>This study aimed to establish the noninferiority of a single-freeze application with CO<sub>2</sub> or N<sub>2</sub>O compared with the standard double freeze with N<sub>2</sub>O for cryotherapy treatment.</p> </sec> <sec> <title>Materials and Methods</title> <p>Sixty women undergoing hysterectomy for reasons other than cervical cancer or precancer were randomized to 1 of 3 techniques as follows: (1) double freeze with N<sub>2</sub>O, (2) single freeze with N<sub>2</sub>O, or (3) single freeze with CO<sub>2</sub>. The cervix was separated and cut into anterior and posterior segments, and the deepest area of necrosis was recorded. Comparisons were made using regression analysis. The margin of noninferiority was defined as 0.8 mm.</p> </sec> <sec> <title>Results</title> <p>On the anterior lip, a single freeze with N<sub>2</sub>O was noninferior to a double freeze of the same gas, but on the posterior lip, the single freeze was not. The single freeze of CO<sub>2</sub> did not provide sufficient depth of necrosis in either lip to infer noninferiority versus the double freeze with N<sub>2</sub>O.</p> </sec> <sec> <title>Conclusions</title> <p>A single freeze with N<sub>2</sub>O is noninferior to a double-freeze technique in the anterior but not the posterior lip. However, the result for posterior lips was close to reaching statistical significance. In addition, CO<sub>2</sub> had approximately 1 mm shallower depth of necrosis compared with N<sub>2</sub>O techniques; however, the clinical implications are unknown. Given the extensive use of CO<sub>2</sub> globally, further clinical evaluation is needed.</p> </sec> </abstract>