Surgical Oncology Department, Erasto Gaertner Hospital, Curitiba, Brazil.
Surgical Oncology Department, Erasto Gaertner Hospital, Curitiba, Brazil.
Fertil Steril. 2017 Aug;108(2):320-324.e1. doi: 10.1016/j.fertnstert.2017.06.016. Epub 2017 Jul 8.
To report the first uterine transposition for fertility preservation in a patient with rectal cancer.
Case report.
Community hospital.
PATIENT(S): A 26-year-old patient with stage cT3N1M0 rectal adenocarcinoma located 5 cm from the anal margin.
INTERVENTION(S): Laparoscopic transposition of the uterus to the upper abdomen, outside of the scope of radiation, was performed to preserve fertility. After the end of radiotherapy, rectosigmoidectomy was performed and the uterus was repositioned into the pelvis.
MAIN OUTCOME MEASURE(S): Uterine and ovarian function preservation.
RESULT(S): The patient had two menstrual periods and exhibited normal variation in ovarian hormones throughout the course of neoadjuvant therapy. Menstruation began 2 weeks after reimplantation into the pelvis, and the cervix exhibited a normal appearance on clinical examination after 6 weeks. Eighteen months after the surgery, the uterus was normal and there was no sign of disease.
CONCLUSION(S): Uterine transposition might represent a valid option for fertility preservation in women who require pelvic radiotherapy and want to bear children. However, studies that assess its viability, effectiveness, and safety are required.
报道首例为保留生育能力而行的直肠癌患者的子宫转位术。
病例报告。
社区医院。
一名 26 岁的患者，患有 cT3N1M0 期直肠腺癌，肿瘤位于距肛门缘 5cm 处。
腹腔镜下将子宫转位至腹部，避开放射范围，以保留生育能力。放疗结束后，行直肠乙状结肠切除术，并将子宫重新植入骨盆。
子宫和卵巢功能的保留。
患者有两次月经，且在新辅助治疗过程中卵巢激素的变化正常。植入盆腔后 2 周开始出现月经，6 周后宫颈在临床检查中外观正常。手术后 18 个月，子宫正常，无疾病迹象。
对于需要盆腔放疗并希望生育的女性，子宫转位可能是保留生育能力的有效选择。但是，需要研究来评估其可行性、有效性和安全性。
