Tamate Masato, Matsuura Motoki, Someya Masayuki, Mariya Tasuku, Ishioka Shinichi, Saito Tsuyoshi
Obstetrics and Gynecology, Sapporo Medical University, Sapporo, JPN.
Cureus. 2024 Oct 16;16(10):e71626. doi: 10.7759/cureus.71626. eCollection 2024 Oct.
Vaginal trachelectomy, which involves resecting the cervix and its parametrium, is a fertility-sparing option for the treatment of early-stage cervical cancer. Although no consensus has been reached on whether simple or radical trachelectomy is preferable, the vaginal approach is typically avoided for tumors larger than 2 cm due to concerns about recurrence. However, some evidence suggests that fertility preservation may still be viable for select patients with larger tumors. This case report describes a woman with bulky cervical cancer who wished to preserve her fertility. After undergoing neoadjuvant chemotherapy (NAC) and vaginal radical trachelectomy (VRT), she achieved a favorable oncological and perinatal outcome, successfully giving birth to a near-full-term baby. The report outlines the patient's management before, during, and after the procedure, including perinatal care. While careful selection of candidates is crucial, accumulating case reports and future trials are expected to shed more light on this treatment approach.
阴道宫颈切除术,即切除子宫颈及其宫旁组织,是一种保留生育功能的早期宫颈癌治疗方法。尽管对于单纯性或根治性宫颈切除术哪种更可取尚未达成共识,但由于担心复发,对于直径大于2cm的肿瘤通常避免采用经阴道入路。然而,一些证据表明,对于部分肿瘤较大的患者,保留生育功能仍有可能。本病例报告描述了一名患有巨大宫颈癌且希望保留生育功能的女性。在接受新辅助化疗(NAC)和阴道根治性宫颈切除术(VRT)后,她获得了良好的肿瘤学和围产期结局,成功产下一名接近足月的婴儿。该报告概述了患者手术前、手术期间和手术后的管理情况,包括围产期护理。虽然谨慎选择候选人至关重要,但越来越多的病例报告和未来的试验有望进一步阐明这种治疗方法。