Total laparoscopic radical trachelectomy in the treatment of early squamous cell cervical cancer: a retrospective study with 8-year follow-up

Abstract

Objective: The objective of this study was to evaluate the surgical, oncologic, and obstetrical outcomes of total laparoscopic radical trachelectomy (LRT) in patients with early-stage squamous cell cervical cancer who want to preserve their fertility.

Methods: Twenty-five patients with early-stage cervical cancer were treated by total LRT from January 2005 to December 2012. Data regarding operational time, blood loss, intraoperative-and post-operative complications, recurrence, and subsequent pregnancies were recorded. Other published reports on LRT were also reviewed.

Results: The median age of the patients was 29 years (range 22-34 years). The median surgical time was 232 min (range, 180-340 min). The median blood loss was 120 ml (range, 50-200 ml), and the median length of hospitalization was 3.3 days (range, 2-4 days). The median time to return to daily activities was 2 days (range, 1-3 days). No intra-operative complications occurred; three patients had post-operative complications. The median follow-up time was 66 months (range, 1-82 months), and no recurrences were observed. Twelve patients attempted to conceive during the follow-up, and nine succeeded.

Conclusions: In this retrospective analysis, total LRT was an effective and safe procedure for patients with early-stage cervical carcinoma who wished to preserve fertility. A larger prospective study with long-term pregnancy and survival analyses is warranted.

Keywords: Cervical cancer; Laparoscopic; Radical trachelectomy.