[Role of radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy in treating early cervical carcinoma]

Abstract

Objective: To investigate the possibility and effect of radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy in treating women with early cervical cancers who desired to maintain fertility.

Methods: From August 2001 through May 2003, we performed vaginal radical trachelectomy with laparoscopic lymphadenectomy on 12 patients with biopsy-proven early stage cervical carcinomas. Subjects were selected for this treatment on the basis of favorable cervical tumors and a desire to maintain fertility. Pelvic lymphadenectomies were performed in all patients. Vaginal radical trachelectomy was performed immediately if lymph nodes were negative.

Results: Twelve women underwent this procedure. The median age was 27.6 years (range 24 - 31 years); 10 were nulligravid and 2 were multipara. Mean operative time was 142 min (115 - 178 min), with a mean blood loss of 180 ml (120 - 230 ml), and an average hospital stay of 6.7 days. There was no intra- or post-operative complication. With an average follow-up of 21.5 months, there have been no recurrences. One woman has become pregnant.

Conclusions: Radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy permits preservation of fertility in selected patients. It is mini-invasive, and needs shorter recovery time.