Trachelectomy: a review of fifty-five cases.

A retrospective chart review was performed on all patients undergoing trachelectomy in the Roanoke Valley between January 1, 1975 and April 30, 1987. During this period a total of 55 trachelectomies were performed. Fifty-three of the 55 trachelectomies (96%) were performed by the vaginal approach. Forty-seven of the 55 patients (85%) had symptomatic genital prolapse as an indication for trachelectomy. Only seven of the patients had trachelectomy performed as a lone surgical procedure, whereas 48 of the 55 patients (87%) had additional surgical procedures performed at the time of trachelectomy. The most frequently performed concomitant operation was anterior and posterior colporrhaphy. Trachelectomy is an operation that should be performed only when clear indications exist and not on a prophylactic basis. With the use of sound surgical technique, trachelectomy can be performed with very acceptable morbidity. A technique for vaginal trachelectomy is described.