Segarra-Vidal Blanca, Persson Jan, Falconer Henrik
Gynecology Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain
Department of Obstetrics and Gynecology, Lund University Hospital, Lund, Sweden.
Int J Gynecol Cancer. 2021 Jul;31(7):1068-1074. doi: 10.1136/ijgc-2020-001782. Epub 2021 Mar 11.
Radical trachelectomy is the 'cornerstone' of fertility-sparing surgery in patients with early-stage cervical cancer wishing to preserve fertility. Growing evidence has demonstrated the oncologic safety and subsequent favorable pregnancy outcomes in well-selected cases. In the absence of prospective trials, the decision on the appropriate surgical approach (vaginal, open, or minimally invasive surgery) should be based on local resources and surgeons' preferences. Radical trachelectomy has the potential to preserve fertility in a large proportion of women with early-stage cervical cancer. However, prematurity and premature rupture of membranes are common obstetric complications after radical trachelectomy for cervical cancer. A multidisciplinary approach is crucial to optimize the balance between oncologic and obstetric outcomes. The purpose of this review is to provide an updated overview of the technical, oncologic, and obstetric aspects of radical trachelectomy.
根治性宫颈切除术是希望保留生育能力的早期宫颈癌患者保留生育功能手术的“基石”。越来越多的证据表明,在精心挑选的病例中,该手术具有肿瘤学安全性以及随后良好的妊娠结局。由于缺乏前瞻性试验,关于合适的手术方式(经阴道、开放或微创手术)的决策应基于当地资源和外科医生的偏好。根治性宫颈切除术有可能使大部分早期宫颈癌女性保留生育能力。然而,早产和胎膜早破是宫颈癌根治性宫颈切除术后常见的产科并发症。多学科方法对于优化肿瘤学和产科结局之间的平衡至关重要。本综述的目的是提供根治性宫颈切除术在技术、肿瘤学和产科方面的最新概述。