Abstract
INTRODUCTION
The carbon dioxide laser destroys tissue by delivering intense energy to produce boiling of intra- and extra-cellular fluid. The vaporization of tissue leaves a crater, lined by debris and carbon particles. Beneath this crater is a zone of necrotic tissue, damaged by the conduction of energy (1,2). The details and extent of this zone have been demonstrated using transmission electron microscopy (TEM) around laser burns in the brain and spinal cord of cats (3,4), the tongue of dogs (5) and human skin (6).
The carbon dioxide laser has recently been introduced to gynecological practice to treat premalignant lesions of the cervix (7-11). These lesions, now termed cervical intraepithelial neoplasia (CIN) (12,13), involve not only surface squamous epithelium but also the epithelium that invaginates the underlying stroma as crypts or clefts (14). From the data of Przybora and Plutowa (15), Anderson and Hartley (16,17) and Abdul-Karim et al. (18) the depth of this crypt involvement rarely extends beyond 5 mm. These findings would suggest that to treat CIN successfully by laser, at least 5 mm depth of total tissue destruction, that is depth of crater plus underlying necrosis, should be achieved.
This study was therefore undertaken to examine, using TEM, the extent of this zone of necrosis for laser burns in the human cervix.
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