Abdominal Radical Trachelectomy in Fertility-Sparing Treatment of Early-Stage Cervical Cancer
Abdominal Radical Trachelectomy in Fertility-Sparing Treatment of Early-Stage Cervical Cancer
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DOI：
10.1111/igc.0b013e3181b9549a
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发表时间：
2009-11-01
影响因子：
4.8
通讯作者：
Hill, Martin
中科院分区：
文献类型：
--
作者：
Cibula, David;Slama, Jiri;Hill, Martin
背景：腹部根治性宫颈切除术（ART）是早期宫颈癌患者保留生育能力的手术之一。与阴道根治性宫颈切除术相比，发表的结果ART是迄今limited.Methods：入组的妇女被称为ART无论是通过腹腔镜或开腹手术。主要的入选标准是阶段IA 2或IB 1与颅骨的程度，允许保留至少1厘米的子宫颈内canal.Results：共有24名妇女被称为该程序，但生育能力不能保存在7（29%）。4名妇女因颅骨手术切缘阳性（n = 2）或前哨淋巴结大转移（n = 2）而接受了根治性子宫切除术。我们发现肿瘤体积和不能保持生育能力之间没有相关性。在4例患者（17%）中发现了阳性前哨淋巴结;没有假阴性结果。9名妇女（53%）谁曾试图怀孕到目前为止，6（67%）已怀孕，5分娩，其中2个早产儿。结论：生育能力不能保存，因为积极的颅缘或涉及淋巴结在几乎三分之一的患者最初提到的根治性tracelectomy。选择合适患者的主要标准应是肿瘤的颅侧范围。经腹根治性宫颈切除术可获得满意的产科结局。
Background: Abdominal radical trachelectomy (ART) is one of the fertility-sparing procedures in women with early-stage cervical cancer. In comparison with vaginal radical trachelectomy, the published results of ART are so far limited.Methods: Enrolled were women referred for ART either by laparoscopy or laparotomy. The main inclusion criterion was stage IA2 or IB1 with a cranial extent that allows for preservation of at least 1 cm of the endocervical canal.Results: A total of 24 women were referred for the procedure, but fertility could not be preserved in 7 (29%) of them. Four women underwent immediate completion of radical hysterectomy because of a positive cranial surgical margin (n = 2) or sentinel node macrometastasis (n = 2) oil frozen section. We found no correlation between tumor volume and inability to preserve fertility. A positive sentinel node was identified in 4 patients (17%); there were no false-negative results. Of the 9 women (53%) who have tried to conceive so far, 6 (67%) have conceived and 5 given birth, 2 of which were premature deliveries.Conclusions: Fertility cannot be preserved because of positive cranial margins or involved lymph nodes in almost one third of patients originally referred for radical trachelectomy. The main criterion for the selection of suitable patients should be the cranial extent of the tumor. Abdominal radical trachelectomy allows for achievement of satisfactory obstetrical Outcomes.