OBJECTIVES: Radical trachelectomy has emerged as a reasonable fertility-sparing operation for selected patients with stage I cervical cancer. The purpose of this report is to describe our technique of radical abdominal trachelectomy, a fertility-sparing operation in women with cervical cancer, and review the current literature on this procedure. METHODS: A review of a prospectively maintained database of all fertility-sparing radical trachelectomy procedures performed at our institution. RESULTS: Between 11/01 and 3/06, we performed a total of 42 fertility-preserving radical trachelectomies with pelvic lymphadenectomy for women with invasive cervical cancer. We had previously reported on 2 pediatric abdominal trachelectomies, which are excluded from this report. Five of the remaining 40 cases had undergone a radical abdominal trachelectomy, and 35 cases were performed laparoscopically with a radical vaginal approach. The characteristics of the 5 adult patients who underwent abdominal radical trachelectomy included stage IB1 disease in all cases, a mean age of 36 years (range, 33-39), and a mean estimated blood loss of 280 ml (range, 50-400); 1 patient with squamous cell carcinoma needed completion radical hysterectomy at the time of trachelectomy due to disease extending into the endometrium, and 1 patient needed postoperative chemoradiation due to a positive parametrial lymph node. The remaining 3 patients resumed normal menstruation postoperatively. All patients remain disease-free at the time of this report. The only remaining uterine blood supply in these patients are the utero-ovarian vessels. There were no postoperative complications, and transurethral Foley catheters were removed in all cases within 2 weeks. CONCLUSIONS: Radical abdominal trachelectomy with pelvic lymphadenectomy is a feasible operation for selected women with stage I cervical cancer who desire to preserve reproductive function. Menstruation and reproductive function may be preserved after bilateral uterine vessel ligation. The procedure expands the inclusion criteria of radical vaginal trachelectomy to patients with distorted cervicovaginal anatomy in which the vaginal approach may not be feasible.
OBJECTIVES: Radical trachelectomy has emerged as a reasonable fertility-sparing operation for selected patients with stage I cervical cancer. The purpose of this report is to describe our technique of radical abdominal trachelectomy, a fertility-sparing operation in women with cervical cancer, and review the current literature on this procedure. METHODS: A review of a prospectively maintained database of all fertility-sparing radical trachelectomy procedures performed at our institution. RESULTS: Between 11/01 and 3/06, we performed a total of 42 fertility-preserving radical trachelectomies with pelvic lymphadenectomy for women with invasive cervical cancer. We had previously reported on 2 pediatric abdominal trachelectomies, which are excluded from this report. Five of the remaining 40 cases had undergone a radical abdominal trachelectomy, and 35 cases were performed laparoscopically with a radical vaginal approach. The characteristics of the 5 adult patients who underwent abdominal radical trachelectomy included stage IB1 disease in all cases, a mean age of 36 years (range, 33-39), and a mean estimated blood loss of 280 ml (range, 50-400); 1 patient with squamous cell carcinoma needed completion radical hysterectomy at the time of trachelectomy due to disease extending into the endometrium, and 1 patient needed postoperative chemoradiation due to a positive parametrial lymph node. The remaining 3 patients resumed normal menstruation postoperatively. All patients remain disease-free at the time of this report. The only remaining uterine blood supply in these patients are the utero-ovarian vessels. There were no postoperative complications, and transurethral Foley catheters were removed in all cases within 2 weeks. CONCLUSIONS: Radical abdominal trachelectomy with pelvic lymphadenectomy is a feasible operation for selected women with stage I cervical cancer who desire to preserve reproductive function. Menstruation and reproductive function may be preserved after bilateral uterine vessel ligation. The procedure expands the inclusion criteria of radical vaginal trachelectomy to patients with distorted cervicovaginal anatomy in which the vaginal approach may not be feasible.
Authors: Gloria Salvo; Pedro T Ramirez; Mario Leitao; David Cibula; Christina Fotopoulou; Ali Kucukmetin; Gabriel Rendon; Myriam Perrotta; Reitan Ribeiro; Marcelo Vieira; Glauco Baiocchi; Henrik Falconer; Jan Persson; Xiaohua Wu; Mihai Emil Căpilna; Nicolae Ioanid; Berit Jul Mosgaard; Igor Berlev; Dilyara Kaidarova; Alexander Babatunde Olawaiye; Kaijiang Liu; Silvana Pedra Nobre; Roman Kocian; Srdjan Saso; Stuart Rundle; Florencia Noll; Audrey Tieko Tsunoda; Kolbrun Palsdottir; Xiaoqi Li; Elena Ulrikh; Zhijun Hu; Rene Pareja Journal: Int J Gynecol Cancer Date: 2019-02-13 Impact factor: 3.437
Authors: Stephanie L Wethington; Yukio Sonoda; Kay J Park; Kaled M Alektiar; William P Tew; Dennis S Chi; Mario M Leitao; Elizabeth L Jewell; Richard R Barakat; Nadeem R Abu-Rustum Journal: Int J Gynecol Cancer Date: 2013-07 Impact factor: 3.437
Authors: Nadeem R Abu-Rustum; Nikki Neubauer; Yukio Sonoda; Kay J Park; Mary Gemignani; Kaled M Alektiar; William Tew; Mario M Leitao; Dennis S Chi; Richard R Barakat Journal: Gynecol Oncol Date: 2008-08-16 Impact factor: 5.482
Authors: Margaret H Einstein; Kay J Park; Yukio Sonoda; Jeanne Carter; Dennis S Chi; Richard R Barakat; Nadeem R Abu-Rustum Journal: Gynecol Oncol Date: 2008-10-29 Impact factor: 5.482