Radical trachelectomy and pelvic lymphadenectomy with uterine preservation in the treatment of cervical cancer

2003 ◽  
Vol 188 (1) ◽  
pp. 29-34 ◽  
Author(s):  
John B. Schlaerth ◽  
Nicola M. Spirtos ◽  
Alan C. Schlaerth
Keyword(s):  
Cervical Cancer ◽  
Pelvic Lymphadenectomy ◽  
Radical Trachelectomy ◽  
Uterine Preservation

scholarly journals Extraperitoneal radical trachelectomy with pelvic lymphadenectomy

2019 ◽  
Vol 29 (4) ◽  
pp. 842-842
Author(s):  
Kotaro Shimura ◽  
Seiji Mabuchi
Keyword(s):  
Cervical Cancer ◽  
Surgical Approach ◽  
Uterine Cervix ◽  
Early Stage ◽  
Foley Catheter ◽  
Pelvic Lymphadenectomy ◽  
Radical Trachelectomy ◽  
Uterosacral Ligaments ◽  
Early Stage Cervical Cancer ◽  
Umbilical Ligament

Radical trachelectomy combined with pelvic lymphadenectomy has been used to treat patients with early-stage cervical cancer who wish to preserve their fertility. Vaginal, abdominal, laparoscopic, and robotic approaches have been employed during this procedure, but all cause peritoneal damage, which could result in periadnexal adhesion. As periadnexal adhesion can lead to female infertility due to restricted sweeping of the fimbria over the ovary, it is important to minimize peritoneal damage during the fertility-preserving surgery. Aiming to minimize peritoneal damage, we recently developed a new surgical approach. The techniques used are similar to those used for type III radical hysterectomy; however, all procedures are performed via the extraperitoneal approach.In this video article, we describe a step-by-step technique of this new fertility-preserving surgical procedure. Surgical procedures are as follows: (1) extraperitoneal pelvic lymphadenectomy, (2) excision of the vesicohypogastric fascia and median umbilical ligament, (3) bladder dissection from the peritoneum and identification of uterine cervix, (4) transection of the cardinal ligaments and vesicouterine ligaments, (5) transection of the vagina, (6) excision of the rectovaginal and uterosacral ligaments, (7) transection of the uterine cervix, (8) cervical cerclage and placement of a Foley catheter, (9) anastomosis of the uterine cervix, (10) suture of the median umbilical ligament and vesicohypogastric fascia. During these procedures, the uterine arteries, inferior hypogastric nerve, and pelvic splanchnic nerve were preserved. The advantages of this new surgical approach are first, peritoneal injuries can be completely avoided as the procedure is performed extraperitoneally, and second, it can be carried out using conventional low-cost instruments. In view of these features, we consider that this technique could be an ideal treatment option for selected women with early-stage cervical cancer. The oncological and reproductive outcomes of this new surgical approach need to be evaluated in future clinical studies.

Robotic Uterine Artery Preservation and Nerve-Sparing Radical Trachelectomy With Bilateral Pelvic Lymphadenectomy in Early-Stage Cervical Cancer

2011 ◽  
Vol 21 (2) ◽  
pp. 391-396 ◽  
Author(s):  
Dae Gy Hong ◽  
Yoon Soon Lee ◽  
Nae Yoon Park ◽  
Gun Oh Chong ◽  
Il Soo Park ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Blood Loss ◽  
Uterine Artery ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Nerve Sparing ◽  
Radical Trachelectomy ◽  
Estimated Blood Loss ◽  
Early Stage Cervical Cancer ◽  
The Mean

Objective:The aim of the study was to evaluate the safety and feasibility of robotic uterine artery preservation and nerve-sparing radical trachelectomy with pelvic lymphadenectomy using the da Vinci surgical system.Methods:Three patients who were diagnosed with early-stage cervical cancer underwent robotic uterine artery preservation and nerve-sparing radical trachelectomy with bilateral lymphadenectomy from January 2010 to March 2010. The data were compared with those of 4 cases of total laparoscopic nerve-sparing radical trachelectomy that were performed from July 2004 to May 2005 and were previously reported.Results:In the robotic group, the mean console time was 275 minutes (range, 240-305 minutes). The mean postoperative hemoglobin change was 0.4 g/dL (range, 0.2-0.6 g/dL). The mean estimated blood loss was 23 mL (range, 15-40 mL), which is less than that of the laparoscopic group. There were no metastases detected in any of the cases, and the resection margins were negative in both groups.Conclusions:The robotic uterine artery preservation and nerve-sparing radical trachelectomy with pelvic lymphadenectomy were efficient in reducing blood loss and feasible methods such as other approaches.

Type B Laparoscopic Radical Trachelectomy With Pelvic Lymphadenectomy for Early Cervical Cancer

2017 ◽  
Vol 24 (1) ◽  
pp. 14-15 ◽  
Author(s):  
Camille Martel-Billard ◽  
Emilie Faller ◽  
Maia Delaine ◽  
Thomas Boisramé ◽  
Jean-Jacques Baldauf ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Pelvic Lymphadenectomy ◽  
Type B ◽  
Radical Trachelectomy ◽  
Early Cervical Cancer

scholarly journals VARIOUS TECHNIQUES FOR RADICAL TRACHELECTOMY: ONCOLOGIC AND REPRODUCTIVE OUTCOMES

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.

scholarly journals Does Radical trachelectomy (RT) during pregnancy have higher obstetrical and oncological risks than RT before pregnancy?

2021 ◽  
Author(s):  
Shota Shinkai ◽  
Shinichi Ishioka ◽  
Tasuku Mariya ◽  
Yuya Fujibe ◽  
Miseon Kim ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Young Patients ◽  
Uterine Cervical Cancer ◽  
Pelvic Lymphadenectomy ◽  
Radical Trachelectomy ◽  
Surgical Time ◽  
Group A ◽  
Oncological Results ◽  
New Treatment ◽  
Group B

Abstract Purpose Radical trachelectomy (RT) with pelvic lymphadenectomy has become a new treatment option for young patients with uterine cervical cancer stages 1A2–1B1 who desire the preservation of their fertility. However, the application of RT for pregnant patients is still controversial. We comparatively studied both obstetrical and oncological outcomes of pregnant patients who underwent vaginal RT during pregnancy and those who underwent vaginal RT before pregnancy. Methods Both obstetrical and oncological results of eight patients who underwent vaginal RT with pelvic lymphadenectomy during pregnancy in our institute between 2010 and 2020 (Group A), and ten pregnant patients who underwent vaginal RT with pelvic lymphadenectomy before pregnancy during the same period (Group B) were reviewed based on their medical charts. Results There were no significant differences in blood loss, surgical time, or surgical completeness between Group A and Group B. Nor were there significant differences in obstetrical outcomes between the two groups. However, two of the eight patients in Group A had recurrence of the cancer. None of the patients in Group B has shown any signs of recurrence thus far. Conclusion Vaginal RT during pregnancy does not affect the obstetrical prognoses of patients with early invasive uterine cervical cancer, and it might be a tolerable treatment modality for them. However, oncologically, it should be performed carefully as there is a risk of recurrence.

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