Comparison of depth of necrosis using cryotherapy by gas and number of freeze cycles

Miriam Cremer, Lauren Ditzian, Jennifer L. Winkler, José Jerónimo, Jered Singleton, Henry Valdivia Franco, Mauricio Maza, Elizabeth Conlisk, Julia Gage, Philip E. Castle, Carlos Santos

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE: This study aimed to establish the noninferiority of a single-freeze application with CO2 or N2O compared with the standard double freeze with N2O for cryotherapy treatment.

MATERIALS AND METHODS: 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 N2O, (2) single freeze with N2O, or (3) single freeze with CO2. 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.

RESULTS: On the anterior lip, a single freeze with N2O was noninferior to a double freeze of the same gas, but on the posterior lip, the single freeze was not. The single freeze of CO2 did not provide sufficient depth of necrosis in either lip to infer noninferiority versus the double freeze with N2O.

CONCLUSIONS: A single freeze with N2O 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, CO2 had approximately 1 mm shallower depth of necrosis compared with N2O techniques; however, the clinical implications are unknown. Given the extensive use of CO2 globally, further clinical evaluation is needed.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalJournal of Lower Genital Tract Disease
Volume19
Issue number1
DOIs
StatePublished - Jan 13 2015
Externally publishedYes

Fingerprint

Cryotherapy
Lip
Necrosis
Gases
Hysterectomy
Cervix Uteri
Uterine Cervical Neoplasms
Regression Analysis

Keywords

  • carbon dioxide
  • cervical precancer
  • cryotherapy
  • depth of necrosis
  • nitrous oxide

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Cremer, M., Ditzian, L., Winkler, J. L., Jerónimo, J., Singleton, J., Franco, H. V., ... Santos, C. (2015). Comparison of depth of necrosis using cryotherapy by gas and number of freeze cycles. Journal of Lower Genital Tract Disease, 19(1), 1-6. https://doi.org/10.1097/LGT.0000000000000042

Comparison of depth of necrosis using cryotherapy by gas and number of freeze cycles. / Cremer, Miriam; Ditzian, Lauren; Winkler, Jennifer L.; Jerónimo, José; Singleton, Jered; Franco, Henry Valdivia; Maza, Mauricio; Conlisk, Elizabeth; Gage, Julia; Castle, Philip E.; Santos, Carlos.

In: Journal of Lower Genital Tract Disease, Vol. 19, No. 1, 13.01.2015, p. 1-6.

Research output: Contribution to journalArticle

Cremer, M, Ditzian, L, Winkler, JL, Jerónimo, J, Singleton, J, Franco, HV, Maza, M, Conlisk, E, Gage, J, Castle, PE & Santos, C 2015, 'Comparison of depth of necrosis using cryotherapy by gas and number of freeze cycles', Journal of Lower Genital Tract Disease, vol. 19, no. 1, pp. 1-6. https://doi.org/10.1097/LGT.0000000000000042
Cremer, Miriam ; Ditzian, Lauren ; Winkler, Jennifer L. ; Jerónimo, José ; Singleton, Jered ; Franco, Henry Valdivia ; Maza, Mauricio ; Conlisk, Elizabeth ; Gage, Julia ; Castle, Philip E. ; Santos, Carlos. / Comparison of depth of necrosis using cryotherapy by gas and number of freeze cycles. In: Journal of Lower Genital Tract Disease. 2015 ; Vol. 19, No. 1. pp. 1-6.
@article{d4c4f7c8884c4528a58b870ff246578d,
title = "Comparison of depth of necrosis using cryotherapy by gas and number of freeze cycles",
abstract = "OBJECTIVE: This study aimed to establish the noninferiority of a single-freeze application with CO2 or N2O compared with the standard double freeze with N2O for cryotherapy treatment.MATERIALS AND METHODS: 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 N2O, (2) single freeze with N2O, or (3) single freeze with CO2. 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.RESULTS: On the anterior lip, a single freeze with N2O was noninferior to a double freeze of the same gas, but on the posterior lip, the single freeze was not. The single freeze of CO2 did not provide sufficient depth of necrosis in either lip to infer noninferiority versus the double freeze with N2O.CONCLUSIONS: A single freeze with N2O 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, CO2 had approximately 1 mm shallower depth of necrosis compared with N2O techniques; however, the clinical implications are unknown. Given the extensive use of CO2 globally, further clinical evaluation is needed.",
keywords = "carbon dioxide, cervical precancer, cryotherapy, depth of necrosis, nitrous oxide",
author = "Miriam Cremer and Lauren Ditzian and Winkler, {Jennifer L.} and Jos{\'e} Jer{\'o}nimo and Jered Singleton and Franco, {Henry Valdivia} and Mauricio Maza and Elizabeth Conlisk and Julia Gage and Castle, {Philip E.} and Carlos Santos",
year = "2015",
month = "1",
day = "13",
doi = "10.1097/LGT.0000000000000042",
language = "English (US)",
volume = "19",
pages = "1--6",
journal = "Journal of Lower Genital Tract Disease",
issn = "1089-2591",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Comparison of depth of necrosis using cryotherapy by gas and number of freeze cycles

AU - Cremer, Miriam

AU - Ditzian, Lauren

AU - Winkler, Jennifer L.

AU - Jerónimo, José

AU - Singleton, Jered

AU - Franco, Henry Valdivia

AU - Maza, Mauricio

AU - Conlisk, Elizabeth

AU - Gage, Julia

AU - Castle, Philip E.

AU - Santos, Carlos

PY - 2015/1/13

Y1 - 2015/1/13

N2 - OBJECTIVE: This study aimed to establish the noninferiority of a single-freeze application with CO2 or N2O compared with the standard double freeze with N2O for cryotherapy treatment.MATERIALS AND METHODS: 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 N2O, (2) single freeze with N2O, or (3) single freeze with CO2. 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.RESULTS: On the anterior lip, a single freeze with N2O was noninferior to a double freeze of the same gas, but on the posterior lip, the single freeze was not. The single freeze of CO2 did not provide sufficient depth of necrosis in either lip to infer noninferiority versus the double freeze with N2O.CONCLUSIONS: A single freeze with N2O 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, CO2 had approximately 1 mm shallower depth of necrosis compared with N2O techniques; however, the clinical implications are unknown. Given the extensive use of CO2 globally, further clinical evaluation is needed.

AB - OBJECTIVE: This study aimed to establish the noninferiority of a single-freeze application with CO2 or N2O compared with the standard double freeze with N2O for cryotherapy treatment.MATERIALS AND METHODS: 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 N2O, (2) single freeze with N2O, or (3) single freeze with CO2. 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.RESULTS: On the anterior lip, a single freeze with N2O was noninferior to a double freeze of the same gas, but on the posterior lip, the single freeze was not. The single freeze of CO2 did not provide sufficient depth of necrosis in either lip to infer noninferiority versus the double freeze with N2O.CONCLUSIONS: A single freeze with N2O 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, CO2 had approximately 1 mm shallower depth of necrosis compared with N2O techniques; however, the clinical implications are unknown. Given the extensive use of CO2 globally, further clinical evaluation is needed.

KW - carbon dioxide

KW - cervical precancer

KW - cryotherapy

KW - depth of necrosis

KW - nitrous oxide

UR - http://www.scopus.com/inward/record.url?scp=84920784354&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84920784354&partnerID=8YFLogxK

U2 - 10.1097/LGT.0000000000000042

DO - 10.1097/LGT.0000000000000042

M3 - Article

C2 - 24886871

AN - SCOPUS:84920784354

VL - 19

SP - 1

EP - 6

JO - Journal of Lower Genital Tract Disease

JF - Journal of Lower Genital Tract Disease

SN - 1089-2591

IS - 1

ER -