ABSTRACT Aim To evaluate perioperative safety and pathological specimen quality in an endoCUT‐based non‐ligation cervical conization strategy. Methods We retrospectively reviewed consecutive patients who underwent cervical conization for suspected or confirmed cervical intraepithelial neoplasia (CIN) or adenocarcinoma in situ (AIS) at Kawasaki Municipal Hospital between November 2023 and June 2025. The endoCUT‐based strategy comprised excision with endoCUT I without descending‐branch uterine artery ligation followed by soft‐coagulation hemostasis using a ball electrode. The primary outcomes were perioperative safety and pathological specimen quality, including margin evaluability and thermal/crush artifact in the endoCUT‐based strategy group. A contemporaneous conventional ligation cohort was summarized as a contextual reference, and any between‐cohort analyses were exploratory. Results Among 50 screened patients, 43 were included: 20 treated with the endoCUT‐based strategy and 23 with conventional ligation. In the endoCUT‐based strategy group, median blood loss was 5 g (range, 5–357) and mean operation time was 24.3 ± 2.1 min. Postoperative rebleeding occurred in 1 patient (5%), and no other clinically significant complications were observed. Additional absorbable topical hemostatic materials were used in 3 patients (15%). Margin status was evaluable in 18 cases, with 1 positive margin (6%); thermal/crush artifact affecting evaluability was infrequent. In supportive contextual analyses, blood loss and operation time were similar between cohorts. Conclusions The endoCUT‐based non‐ligation conization strategy appeared feasible and was associated with favorable short‐term perioperative safety and pathology‐oriented outcomes. Further prospective studies with standardized and longitudinal assessment are warranted to more rigorously evaluate this strategy.
Yoshimura et al. (Mon,) studied this question.