Pedro F Escobar1, Pedro T Ramirez2, Rafael E Garcia Ocasio3, Rene Pareja4, Steve Zimberg5, Michael Sprague5, Michael Frumovitz2. 1. Department of Gynecologic Oncology & Reproductive Medicine, Unit 1362, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, United States; Instituto Gyneco-Oncólogico, San Juan 00926, Puerto Rico. Electronic address: escobarp@mac.com. 2. Department of Gynecologic Oncology & Reproductive Medicine, Unit 1362, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, United States. 3. Department of Obstetrics and Gynecology, Hospital San Lucas, Ponce, Puerto Rico. 4. Gynecologic Oncology Unit, Instituto de Cancerologia Las Americas, Medellin, Colombia. 5. Department of Gynecology, Cleveland Clinic Florida, Weston, FL 33331, United States.
Abstract
OBJECTIVES: The aim of our study was to measure and analyze uterine perfusion utilizing laser angiography with ICG during uterine artery sparing and non-sparing radical trachelectomy. METHODS: Data were collected from all patients diagnosed with early-stage cervical cancer that underwent laser angiography with ICG during open or laparoscopic radical trachelectomy from June 2012 to December 2015. Regression analysis was use to determine the p values and R-squares on fluorescence, surgical time, hospital stay, age and BMI; a p-value<0.05 was considered statistically significant. RESULTS: A total of 20 patients met the inclusion criteria and were included in this study. Ten patients underwent uterine artery-sparing surgery, and ten patients underwent uterine artery non-sparing surgery. The most frequent stage for the entire cohort was IA2 (55%), and the most common histologic subtype was squamous cell carcinoma (49%). Lymph-vascular invasion was noted in 30% of the patients. There was no statistical significance difference in the mean ICG fundal fluorescence intensity between the uterine artery-sparing group 162.5 (range, 137-188) and the uterine artery non-sparing group 160.5 (range, 135-186), p=0.22. In both groups, 100% of the patients regained their menstrual function by postoperative week 8. A total of 4 (40%) pregnancies have occurred in the uterine artery-sparing group and 3 (30%) in the non-uterine artery-sparing group. CONCLUSIONS: Based on our real-time intraoperative angiography observations, there is no need to preserve the uterine artery during radical trachelectomy to maintain uterine viability.
OBJECTIVES: The aim of our study was to measure and analyze uterine perfusion utilizing laser angiography with ICG during uterine artery sparing and non-sparing radical trachelectomy. METHODS: Data were collected from all patients diagnosed with early-stage cervical cancer that underwent laser angiography with ICG during open or laparoscopic radical trachelectomy from June 2012 to December 2015. Regression analysis was use to determine the p values and R-squares on fluorescence, surgical time, hospital stay, age and BMI; a p-value<0.05 was considered statistically significant. RESULTS: A total of 20 patients met the inclusion criteria and were included in this study. Ten patients underwent uterine artery-sparing surgery, and ten patients underwent uterine artery non-sparing surgery. The most frequent stage for the entire cohort was IA2 (55%), and the most common histologic subtype was squamous cell carcinoma (49%). Lymph-vascular invasion was noted in 30% of the patients. There was no statistical significance difference in the mean ICG fundal fluorescence intensity between the uterine artery-sparing group 162.5 (range, 137-188) and the uterine artery non-sparing group 160.5 (range, 135-186), p=0.22. In both groups, 100% of the patients regained their menstrual function by postoperative week 8. A total of 4 (40%) pregnancies have occurred in the uterine artery-sparing group and 3 (30%) in the non-uterine artery-sparing group. CONCLUSIONS: Based on our real-time intraoperative angiography observations, there is no need to preserve the uterine artery during radical trachelectomy to maintain uterine viability.
Authors: László Ungár; László Pálfalvi; Russell Hogg; Pál Siklós; Deborah C M Boyle; Giuseppe Del Priore; J Richard Smith Journal: BJOG Date: 2005-03 Impact factor: 6.531
Authors: Marcelo A Vieira; Gabriel J Rendón; Mark Munsell; Lina Echeverri; Michael Frumovitz; Kathleen M Schmeler; Rene Pareja; Pedro F Escobar; Ricardo Dos Reis; Pedro T Ramirez Journal: Gynecol Oncol Date: 2015-06-18 Impact factor: 5.482
Authors: René Pareja; Gabriel J Rendón; Carlos Millán Sanz-Lomana; Otto Monzón; Pedro T Ramirez Journal: Gynecol Oncol Date: 2013-06-14 Impact factor: 5.482