Lee Nara, Mun Jaehee, Park Soo Jin, Lee Eun Ji, Lee Seungmee, Kim Hee Seung
Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2021 May;64(3):317-321. doi: 10.5468/ogs.19127. Epub 2021 Feb 4.
Radical trachelectomy is conducted in women with early stage cervical cancer who strongly desire fertility preservation. To improve fertility outcomes, the preservation of the uterine artery has been suggested, which can be feasible by minimally invasive surgery using laparoscopy or robots. Although cesarean delivery is required for maternal and fetal health, vaginal delivery is a concern due to the fast delivery process of risk of preterm labor. We report a case of a 32-year-old nulliparous woman with stage IB1 cervical cancer who underwent robot-assisted uterine artery-preserving radical trachelectomy for improving fertility. This case is meaningful because she delivered by vaginal delivery after incision of the fibrotic ring at the level of uterovaginal anastomosis because delivery proceeded too quickly prior to the preparation of the cesarean delivery.
根治性宫颈切除术适用于强烈希望保留生育能力的早期宫颈癌女性患者。为改善生育结局,有人提出保留子宫动脉,这可通过腹腔镜或机器人辅助的微创手术实现。尽管为了母婴健康需要剖宫产,但由于分娩过程快,存在早产风险,经阴道分娩仍是一个问题。我们报告一例32岁未生育的IB1期宫颈癌女性患者,她接受了机器人辅助保留子宫动脉的根治性宫颈切除术以改善生育能力。该病例具有重要意义,因为她在子宫阴道吻合水平的纤维化环切开后经阴道分娩,原因是在剖宫产准备之前分娩进展太快。