The frozen section analysis of conization. A reappraisal of the ends and means.

A retrospective review of 163 consecutive conizations of the cervix is reported to analyze the use of frozen section interpretation of the conization specimen in 115 patients. There were no failures to identify occult invasive cancer on the initial frozen section analysis and no differences of therapeutic significance when the permanent sections were reviewed. The frozen section conization-immediate hysterectomy technique was compared with the clinical course of 29 patients whose hysterectomy was delayed for 6-8 weeks after conization. The total operating time, estimates of operative blood loss, amount of blood required in transfusion, and morbidity were similar in both groups. Total hospital days were significantly decreased with the cone/frozen section/immediate hysterectomy technique. Because frozen section conization/immediate hysterectomy offers additional advantages of a single hospital admission, single anesthetic induction, and single postoperative recovery/convalescent period, this approach continues to deserve serious consideration in the management of patients with CIN when conization is necessary and subsequent hysterectomy is desired.