Pregnancy-related complications after vaginal radical trachelectomy for early-stage invasive uterine cervical cancer
Pregnancy-related complications after vaginal radical trachelectomy for early-stage invasive uterine cervical cancer
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DOI：
10.1007/s10147-007-0688-4
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发表时间：
2007-10-01
影响因子：
3.3
通讯作者：
Saito, Tsuyoshi
中科院分区：
文献类型：
--
作者：
Ishioka, Shin-Ichi;Endo, Toshiaki;Saito, Tsuyoshi
背景：对早期浸润性宫颈癌经阴道根治性沙眼切除术(RT)后妊娠相关并发症进行了研究，并与激光锥切术后的并发症进行了比较。文中还讨论了减少妊娠期阴道放疗相关并发症的策略。对同期手术的2例患者和5例激光锥切术后的妊娠过程进行症状、宫颈长度和感染体征的观察。在激光锥切术和RT组中，宫颈逐渐缩短。然而，在整个妊娠期间，接受圆锥切割术的患者术后剩余宫颈比接受阴道RT的患者长。激光锥切术后，5例患者中有2例在孕36周发生胎膜早破(PROM)，行阴道RT的两例患者分别在孕32周和24周发生胎膜早破(PPROM)。预防早产及继发胎膜早破是早期浸润性宫颈癌经阴道放疗后改善妊娠结局需要解决的重要课题。每天用聚维酮碘消毒阴道，使用乌司他丁阴道栓剂，卧床休息，利托君的使用将是最好的方法，对于Ia2期也可以考虑更保守的方法。
Background Pregnancy-related complications after vaginal radical trachelectomy (RT) for early-stage invasive uterine cervical cancer were studied in comparison with those occurring after laser conization. The strategy to reduce vaginal RT-related complications during pregnancy is also discussed.Methods. Pregnancy courses after vaginal RT in two patients and those after laser conization in five patients, whose operations were performed during the same period, were studied with respect to symptoms, cervical length, and infectious signs.Results. The cervix shortened progressively both in patients with laser conization and in those with RT. However, throughout the pregnancy, the remaining cervix after the operation was longer in patients who had undergone conization than in those who had undergone vaginal RT. After laser conization, two of the five patients suffered from preterm rupture of the membrane (PROM) at 36 weeks of gestation, and both patients who had undergone vaginal RT had premature PROM (pPROM), at 32 and 24 weeks of gestation, respectively.Conclusion. Prevention of preterm labor and the following occurrence of pPROM is a significant task to be resolved in order to improve pregnancy outcome after vaginal RT for early-stage invasive uterine cervical cancer. Daily vaginal disinfection with povidone iodine and the administration of a ulinastatin vaginal suppository, bed rest, and the use of ritodrine would be the best approach, and a more conservative approach for stage Ia2 also might be taken into consideration.