Complications of Sturmdorf's suture in cold knife conization

An, Tae Soon; Jang, Seog Hyun; Oh, Eun Sung; Sim, Jae Hag; Jung, Kang Woo; Weon, Jong Cheon; Kim, Yong Pil

Abstract

OBJECTIVE
It has been recognized that cold knife conization has higher incidence of postoperative hemorrhage and many techniques have been developed in an attempt to control hemorrhage. The aim of this study was to evaluate complications of Sturmdorf's suture in cold knife conization and to investigate various measures employed to reduce blood loss.
METHODS
The results of 85 patients who had cold knife conization for diagnosis or treatment of cervical intraepithelial neoplasia (CIN) from August, 1997 to July, 2003 were reviewed.
RESULTS
Among 85 patients, 83 patients (97.7%) had negative cut margins on conization specimen while 2 patients (2.3%) positive cut margins. 54 patients received no further treatment after cold knife conization and complications occurred in 9 patients (16.7%). Postoperative hemorrhage requiring additional hemostatic procedures occurred in 7 patients (13%), of which 6 patients were rehospitalized and 1 patient was managed at outpatient clinic with gauze packing only. Among 6 rehospitalized patients, hysterectomy was done in 2 patients and electrocoagulation in 1 patient. Packed red cell was transfused in 1 patient and 2 patients were managed with gauze packing only. Postoperative infection was found in 2 patients (3.7%). No other significant complications were noted.
CONCLUSION
Cold knife conization using Sturmdorf's suture could be done to get much more accurate results of biopsy with relatively mild complication in magement of CIN, although several days? admission is needed and the other alternative methods seem to be more convenient.