Sexual and Reproductive Outcomes in Early Stage Cervical Cancer Patients after Excisional Cone as a Fertility-sparing Surgery: An Italian Experience
Sexual and Reproductive Outcomes in Early Stage Cervical Cancer Patients after Excisional Cone as a Fertility-sparing Surgery: An Italian Experience
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发表时间：
2014-02
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通讯作者：
F. Fanfani;F. Landoni;M. L. Gagliardi;A. Fagotti;E. Preti;M. Moruzzi;G. Monterossi;G. Scambia
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作者：
F. Fanfani;F. Landoni;M. L. Gagliardi;A. Fagotti;E. Preti;M. Moruzzi;G. Monterossi;G. Scambia
背景本研究的目的是分析早期宫颈癌患者的性生活和生殖结局的生活质量，这些患者接受切除锥作为保留生育力的治疗。方法在意大利罗马天主教圣心大学妇科肿瘤科和意大利米兰欧洲肿瘤研究所妇科进行一项多中心回顾性分析，研究冷刀锥切加盆腔腹腔镜淋巴结清扫术后的生理、心理、生殖和性功能的具体方面。这项研究的目的是双重的。其目的是分析接受微创手术的患者的生活质量，并将这些数据与根治性宫颈切除术进行比较。结果23例患者，平均年龄30岁，决定参加这项研究。治疗后，所有女性（100%）月经规律，7例（30.4%）痛经增加但不无效; 1例（4.4%）宫颈狭窄; 10例试图怀孕的患者中有6例（60%）获得了一次自然妊娠; 4例（40%）接受了体外受精和胚胎移植，其中只有1例（25%）成功。在性功能评估方面，1例（4.4%）患者出现润滑困难，3例（13%）患者表现出焦虑，6例（26.1%）患者主诉性交困难，均在随后的3个月内解决。所有患者（100%）均获得了完全的心理和身体恢复。结论本研究初步显示了切除性锥切术后性和生殖结局的令人鼓舞的数据。与宫颈切除术的比较肯定需要更长的随访，更多的病例和前瞻性分析。
Background The purpose of this study was to analyze the quality of life in terms of sexual and reproductive outcome in patients suffering from early stage cervical cancer, submitted to an excisional cone as fertility-sparing treatment. Methods A multicenter retrospective analysis about specific dimensions of physical, psychological, reproductive and sexual functions after a cold-knife conization plus pelvic laparoscopic lymphadenectomy was conducted at Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome-Italy and at Division of Gynecology, European Institute of Oncology, Milan-Italy. The aim of this study was twofold. It aimed to analyze the quality of life in patients submitted to minimally invasive surgery and to compare these data with radical trachelectomy. Results Twenty-three patients with an average age of 30 years decided to participate in this study. After the treatment, all women (100%) had regular menstruation, 7 (30.4%) had increased not invalidating dysmenorrhea; 1 (4.4%) experienced a cervical stenosis; 6 among 10 patients that tried to conceive (60%) obtained one spontaneous pregnancy; 4 more (40%) underwent in vitro fertilization and embryo transfer and only 1 of them (25%) was successful. About sexual assessment, 1 patient (4.4%) had trouble in lubricating, 3 (13%) had anxiety about performance, 6 (26.1%) complained of dyspareunia which was resolved within 3 subsequent months. All patients (100%) obtained a complete psychological and physical recovery. Conclusion This study demonstrated preliminary encouraging data about sexual and reproductive outcome after excisional conization. A comparison with trachelectomy surely needs longer follow-ups, more cases and prospective analyses.