Department of Obstetrics and Gynecology, Chao-yang Hospital, Capital Medical University, Beijing, China.
Gynecol Oncol. 2013 Aug;130(2):275-9. doi: 10.1016/j.ygyno.2013.04.470. Epub 2013 May 4.
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.
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.
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.
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.
本研究旨在评估希望保留生育能力的早期宫颈鳞癌患者行完全腹腔镜根治性宫颈切除术（LRT）的手术、肿瘤学和产科结局。
2005 年 1 月至 2012 年 12 月，25 例早期宫颈癌患者接受完全 LRT 治疗。记录手术时间、出血量、术中及术后并发症、复发和随后的妊娠情况。还回顾了其他关于 LRT 的已发表报告。
患者的中位年龄为 29 岁（范围 22-34 岁）。中位手术时间为 232 分钟（范围 180-340 分钟）。中位出血量为 120 毫升（范围 50-200 毫升），中位住院时间为 3.3 天（范围 2-4 天）。中位恢复日常活动的时间为 2 天（范围 1-3 天）。无术中并发症；3 例患者术后出现并发症。中位随访时间为 66 个月（范围 1-82 个月），未观察到复发。12 例患者在随访期间尝试怀孕，9 例成功。
在这项回顾性分析中，完全 LRT 是一种治疗希望保留生育能力的早期宫颈癌患者的有效且安全的方法。需要进行更大规模的前瞻性研究，以进行长期妊娠和生存分析。
