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Fertility sparing surgery in early cervical cancer

Publication at Second Faculty of Medicine |
2009

Abstract

The aim of the study is to evaluate fertility sparing surgery in early stage cervical cancer. Review was done from Medline and PubMed database and abstract book from International Symposium on Radical Hysterectomy Dedicated to Hidekazu Okabayashi - Kyoto 2007.

There are different procedures which preserve fertility and which have different surgical approaches: abdominal radical trachelectomy which is done completely from laparotomy, completely laparoscopic procedure is laparocopic radical trachelectomy and "Dargent radical trachelectomy" which combine laparocopic pelvic lymphadenectomy and vaginal trachelectomy with resection of parametria. The last procedure is conservative trachelectomy that was first introduced by Motol Hospital Prague which combine sentinel lymph node identification, laparoscopic lymphadenectomy, selective extirpation of lymphatic channels from the medial part of lateral parametrium and vaginal extirpation of the cervix.

All procedures have the same oncological outcome if the tumor is less than 20 mm in the biggest diameter. The best pregnancy outcome are in conservative trachelectomy group, very good results was also referred after vaginal radical trachelectomies.

Pregnancy outcome after abdominal radical and laparocopic radical trachelectomies are not satisfactory.