Abdominal radical trachelectomy:: a fertility-preserving option for women with early cervical cancer
Abdominal radical trachelectomy:: a fertility-preserving option for women with early cervical cancer
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DOI：
10.1111/j.1471-0528.2004.00421.x
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发表时间：
2005-03-01
影响因子：
5.8
通讯作者：
Smith, JR
中科院分区：
文献类型：
--
作者：
Ungár, L;Pálfalvi, L;Smith, JR
腹部根治性气管切除术是一种保留生育能力的替代根治性子宫切除术或化疗的年轻女性IA2期至IB期宫颈癌。33例患者接受了该手术。平均年龄30.5岁（23 ~ 37岁）。由于盆腔淋巴结阳性（2例）和累及切除子宫颈与子宫底之间的边缘（1例），3例手术被放弃。在其余30例患者中，10例为IA2期肿瘤，15例为IB1期，5例为IB2期。在中位随访47个月（平均32个月，范围14 - 75个月）期间，未发现复发。除两名患者外，其余患者均在手术后八周内恢复了正常的月经模式。5名患者试图怀孕。三名妇女怀孕，导致一名妊娠早期流产和两名足月剖腹产分娩。我们的经验表明，腹部根治性气管切除术提供了一种治疗IA2至IB期宫颈癌的方法，在保留生育能力的同时，不会明显影响复发率或生存率。它似乎提供了相同的肿瘤安全性标准韦特海姆子宫切除术使用的技术熟悉所有执业妇科肿瘤医生。
Abdominal radical trachelectomy is a fertility-preserving alternative to radical hysterectomy or chemoradiation for young women with stage IA2 to IB cervical cancers. Thirty-three patients were offered this procedure. The mean age was 30.5 years (range 23 - 37). Three procedures were abandoned because of positive pelvic nodes (two patients) and involvement of the margin between the amputated cervix and uterine fundus (one patient). Of the remaining 30 patients, 10 had stage IA2 tumours, 15 had stage IB1 and 5 had stage IB2. During follow up of a median of 47 months (mean 32 months, range 14 - 75 months), no recurrences have been detected. A normal menstrual pattern resumed within eight weeks of surgery in all but two patients. Five patients attempted to conceive. Three women have fallen pregnant, resulting in one first trimester miscarriage and two caesarean section deliveries at term. Our experience suggests that abdominal radical trachelectomy provides a method of treating women with stage IA2 to IB cervical cancers with conservation of fertility without apparently compromising recurrence or survival rates. It appears to provide equivalent oncological safety to a standard Wertheim hysterectomy using a technique familiar to all practising gynaecologic oncologists.