Radical Vaginal Trachelectomy

AbstractRecently, radical vaginal hysterectomy (RVH) has developed into laparoscopically assisted radical vaginal hysterectomy (LARVH), which is associated with the laparoscopical procedure, and it is applied as radical vaginal trachelectomy and semi-radical vaginal hysterectomy. LARVH is indicated for patients with stage IB1 and IIA1 cervical carcinoma, especially those with a tumor size of less than 2 cm, because the cardinal ligaments cannot be resected widely. Although RVH that is associated with laparoscopic pelvic lymphadenectomy is the most used surgical procedure, radical trachelectomy may be performed either abdominally or vaginally (laparoscopic or robotic). One report found that the pregnancy rate was higher in patients who underwent minimally invasive or radical vaginal trachelectomy than in those who underwent radical abdominal trachelectomy.

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Neoadjuvant Chemotherapy Followed by Radical Vaginal Trachelectomy and Adjuvant Chemotherapy for Clear Cell Cancer of the Cervix: A Feasible Approach and Review

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e3182011236 ◽

2011 ◽

Vol 21 (1) ◽

pp. 137-140 ◽

Cited By ~ 8

Author(s):

Piksi Singh ◽

James Nicklin ◽

Timothy Hassall

Keyword(s):

Adjuvant Chemotherapy ◽

Neoadjuvant Chemotherapy ◽

Adjuvant Treatment ◽

Clear Cell ◽

Cell Cancer ◽

Pelvic Lymphadenectomy ◽

Clear Cell Adenocarcinoma ◽

Radical Trachelectomy ◽

Radical Vaginal Trachelectomy ◽

Laparoscopic Pelvic Lymphadenectomy

Background:Clear cell adenocarcinoma of the cervix (CCAC) may affect pediatric and younger women in absence of diethylstilbestrol exposure and other classic predisposing factors for cervical cancer. Prognosis is similar for early-stage CCAC, squamous cell cancer and non-clear cell adenocarcinoma of the cervix. Vaginal radical trachelectomy (VRT) and abdominal radical trachelectomy (ART) with pelvic lymph node dissection have evolved as valuable fertility-preserving treatment options. Neoadjuvant chemotherapy (NACT) before abdominal radical trachelectomy/VRT may reduce tumor size and thereby facilitate surgery. In some cases, adjuvant treatment in the presence of high-risk prognostic features may be required to optimize treatment.Methods:A 13-year-old adolescent with International Federation of Obstetrics and Gynecology stage IB1 CCAC was treated with NACT using carboplatin and paclitaxel (CP) followed by laparoscopic pelvic lymphadenectomy, VRT, and adjuvant chemotherapy.Results:Neoadjuvant chemotherapy using CP was well tolerated with no toxicity. Neoadjuvant chemotherapy reduced the tumor size and facilitated radical vaginal trachelectomy. Adjuvant treatment was recommended in the presence of risk factors. The patient elected to conserve the uterus and underwent 3 further cycles of adjuvant chemotherapy with CP.Conclusions:This is the first reported case of CCAC treated with NACT using CP followed by laparoscopic pelvic lymphadenectomy, VRT, and adjuvant chemotherapy. A successful treatment outcome achieved using this novel approach suggests its applicability in selected cases.

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Radical vaginal trachelectomy (RVT) combined with laparoscopic pelvic lymphadenectomy: Prospective multicenter study of 100 patients with early cervical cancer

Gynecologic Oncology ◽

10.1016/j.ygyno.2006.03.040 ◽

2006 ◽

Vol 103 (2) ◽

pp. 506-511 ◽

Cited By ~ 128

Author(s):

Hermann Hertel ◽

Christhardt Köhler ◽

Dorothee Grund ◽

Peter Hillemanns ◽

Marc Possover ◽

...

Keyword(s):

Cervical Cancer ◽

Multicenter Study ◽

Pelvic Lymphadenectomy ◽

Prospective Multicenter Study ◽

Radical Vaginal Trachelectomy ◽

Laparoscopic Pelvic Lymphadenectomy ◽

Early Cervical Cancer

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Less radical surgery for women with early stage cervical cancer: Our experience on radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy

Gynecologic Oncology Reports ◽

10.1016/j.gore.2019.03.005 ◽

2019 ◽

Vol 28 ◽

pp. 65-67 ◽

Cited By ~ 4

Author(s):

I. Rizzuto ◽

W. MacNab ◽

R. Nicholson ◽

M. Nalam ◽

B. Rufford

Keyword(s):

Cervical Cancer ◽

Radical Surgery ◽

Early Stage ◽

Pelvic Lymphadenectomy ◽

Early Stage Cervical Cancer ◽

Radical Vaginal Trachelectomy ◽

Laparoscopic Pelvic Lymphadenectomy

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Long-term outcomes of radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy after neoadjuvant chemotherapy for the IB1 cervical cancer: A series of 60 cases

International Journal of Surgery ◽

10.1016/j.ijsu.2016.03.019 ◽

2016 ◽

Vol 29 ◽

pp. 38-42 ◽

Cited By ~ 15

Author(s):

Hong Yan ◽

Zhongyu Liu ◽

Xiaoyu Fu ◽

Yan Li ◽

Hongzhi Che ◽

...

Keyword(s):

Cervical Cancer ◽

Neoadjuvant Chemotherapy ◽

Pelvic Lymphadenectomy ◽

Long Term Outcomes ◽

Radical Vaginal Trachelectomy ◽

Laparoscopic Pelvic Lymphadenectomy

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A Review of Fertility Preservation with Radical Vaginal Trachelectomy and Laparoscopic Pelvic Lymphadenectomy in the Treatment of Early Cervical Cancer

Current Women s Health Reviews ◽

10.2174/1573404054064575 ◽

2005 ◽

Vol 1 (2) ◽

pp. 99-104

Author(s):

Johanne Weberpals ◽

Allan Covens

Keyword(s):

Cervical Cancer ◽

Fertility Preservation ◽

Pelvic Lymphadenectomy ◽

Radical Vaginal Trachelectomy ◽

Laparoscopic Pelvic Lymphadenectomy ◽

Early Cervical Cancer

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Radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy for early-stage cervical cancer in patients who desire to preserve fertility

Gynecologic Oncology ◽

10.1016/j.ygyno.2006.10.035 ◽

2007 ◽

Vol 104 (2) ◽

pp. 50-55 ◽

Cited By ~ 11

Author(s):

Yukio Sonoda ◽

Nadeem R. Abu-Rustum

Keyword(s):

Cervical Cancer ◽

Early Stage ◽

Pelvic Lymphadenectomy ◽

Early Stage Cervical Cancer ◽

Radical Vaginal Trachelectomy ◽

Laparoscopic Pelvic Lymphadenectomy

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Laparoscopic pelvic lymphadenectomy and radical vaginal hysterectomy vs. radical abdominal hysterectomy and pelvic lymphadenectomy: a feasibility study

Gynaecological Endoscopy ◽

10.1046/j.1365-2508.1999.00265.x ◽

1999 ◽

Vol 8 (3) ◽

pp. 149-152 ◽

Cited By ~ 3

Author(s):

Ai-Ling Tan ◽

Andrew R. Mackintosh ◽

Renuka Bhat

Keyword(s):

Feasibility Study ◽

Vaginal Hysterectomy ◽

Abdominal Hysterectomy ◽

Pelvic Lymphadenectomy ◽

Laparoscopic Pelvic Lymphadenectomy ◽

Radical Abdominal Hysterectomy

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VARIOUS TECHNIQUES FOR RADICAL TRACHELECTOMY: ONCOLOGIC AND REPRODUCTIVE OUTCOMES

Siberian Journal of Oncology ◽

10.21294/1814-4861-2018-17-5-106-110 ◽

2018 ◽

Vol 17 (5) ◽

pp. 106-110

Author(s):

S. A. Skugarev ◽

Е. G. Novikova ◽

A. S. Shevchyuk

Keyword(s):

Cervical Cancer ◽

Invasive Cervical Cancer ◽

Pelvic Lymphadenectomy ◽

Reproductive Outcomes ◽

Radical Trachelectomy ◽

Russian Science ◽

Advantages And Disadvantages ◽

Russian Science Citation Index ◽

Laparoscopic Pelvic Lymphadenectomy ◽

State Library

The purpose of the studywas to review available data on various techniques for radical trachelectomy, inclusion criteria, advantages and disadvantages.Material and methods.A systematic literature search was conducted in the electronic databases of Medline, Russian Science Citation Index, and Russian State Library in the interval time between 1997 and 2017.Results.To date, only radical trachelectomy has shown its value regarding both aspects of oncologic and reproductive outcomes in patients with invasive cervical cancer. There are currently 5 approaches to radical trachelectomy: transvaginal approach with laparoscopic pelvic lymphadenectomy, abdominal, laparoscopic, robot-assisted and laparoscopic – vaginal approach. Each technique has its advantages and disadvantages.Conclusion.Over the last years, radical trachelectomy has been recognized as a valuable fertility-preserving option for women of child-bearing age with invasive cervical cancer. Radical trachelectomy should be performed by highly skilled surgeons in specialized clinics.

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