OBJECTIVE: Radical trachelectomy in combination with pelvic and parametric lymphadenectomy is indicated in young patients with early cervical cancer and planned pregnancy. If pregnancy occurs, premature delivery is a known problem in these patients. We evaluated if uterine blood supply is decreased after radical trachelectomy as one of various possible causes of preterm birth. METHODS: Between October 2003 and April 2004, 14 consecutive patients with early cervical cancer underwent radical trachelectomy with pelvic and parametric lymphadenectomy. The uterine blood supply was measured as resistance index (RI) by Doppler sonography pre- and postoperatively. Doppler sonography of the uterine artery was also performed in 14 healthy students as a control cohort. RESULTS: Fourteen patients with histologically confirmed adenocarcinoma or squamous carcinoma of the cervix uteri stage Ia1 L1 to 1b1 underwent radical trachelectomy. Mean age of patients was 33.4 years (31-37). On average, 11.5 mm (5-23) of cervical length and 24.6 (14-35) tumor-free lymph nodes were removed. Decrease of RI of the uterine artery was 0.06 on the right side (0.76-0.70) and 0.07 (0.75-0.68) on the left side. The absolute RI values after radical trachelectomy were not different compared to the values in the control group (0.76 versus 0.70 right side, 0.74 versus 0.68 left side). CONCLUSION: Uterine perfusion after radical trachelectomy with pelvic and parametric lymphadenectomy remains unchanged.
OBJECTIVE: Radical trachelectomy in combination with pelvic and parametric lymphadenectomy is indicated in young patients with early cervical cancer and planned pregnancy. If pregnancy occurs, premature delivery is a known problem in these patients. We evaluated if uterine blood supply is decreased after radical trachelectomy as one of various possible causes of preterm birth. METHODS: Between October 2003 and April 2004, 14 consecutive patients with early cervical cancer underwent radical trachelectomy with pelvic and parametric lymphadenectomy. The uterine blood supply was measured as resistance index (RI) by Doppler sonography pre- and postoperatively. Doppler sonography of the uterine artery was also performed in 14 healthy students as a control cohort. RESULTS: Fourteen patients with histologically confirmed adenocarcinoma or squamous carcinoma of the cervix uteri stage Ia1 L1 to 1b1 underwent radical trachelectomy. Mean age of patients was 33.4 years (31-37). On average, 11.5 mm (5-23) of cervical length and 24.6 (14-35) tumor-free lymph nodes were removed. Decrease of RI of the uterine artery was 0.06 on the right side (0.76-0.70) and 0.07 (0.75-0.68) on the left side. The absolute RI values after radical trachelectomy were not different compared to the values in the control group (0.76 versus 0.70 right side, 0.74 versus 0.68 left side). CONCLUSION: Uterine perfusion after radical trachelectomy with pelvic and parametric lymphadenectomy remains unchanged.
Authors: Alpa M Nick; Michael M Frumovitz; Pamela T Soliman; Kathleen M Schmeler; Pedro T Ramirez Journal: Gynecol Oncol Date: 2011-10-27 Impact factor: 5.482