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Abdominal Radical Trachelectomy: A Romanian Series

Căpîlna, Mihai Emil MD, PhD*; Ioanid, Nicolae MD, PhD; Scripcariu, Viorel MD, PhD; Gavrilescu, Madalina Mihaela MD; Szabo, Bela MD, PhD*

International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0000000000000076
Surgeons Corner
Abstract

Objective: Abdominal radical trachelectomy (ART) is one of the fertility-sparing procedures in women with early-stage cervical cancer. The published results of ART, in comparison with vaginal radical trachelectomy, so far are limited.

Materials and Methods: This retrospective study comprises all cases of female patients referred to ART with early-stage cervical cancer from 2 gynecologic oncology centers in Romania.

Results: A total of 29 women were referred for ART, but subsequently, fertility could not be preserved in 3 of them. Eleven women had stage IA2 disease (42.3%), 14 (53.8%) women had stage IB1 disease, and 1 (3.8%) woman had stage IB2 disease. Histologic subtypes were 15 (57.6%) squamous, 8 (30.7%) adenocarcinoma, and 3 (11.5%) adenosquamous. There were no major intraoperative complications in both hospitals. Early postoperative complications were mainly related to the type C parametrectomy—bladder dysfunction for more than 7 days (8 [30.7%] women) and prolonged constipation (6 [23.0%] women). Other complications consisted in symptomatic lymphocele in 2 (7.6%) patients, which were drained. Median follow-up time was 20 months (range, 4–43 months). Up to the present time, there has been 1 (3.8%) recurrence in our series. Most patients did not experience late postoperative complications. Three (11.5%) women are amenorrheic, and 1 (3.8%) woman developed a cervical stenosis. Of the 23 women who have normal menstruation and maintained their fertility, a total of 7 (30.4%) women have attempted pregnancy, and 3 (42.8%) of them achieved pregnancy spontaneously. These pregnancies ended in 2 first trimester miscarriages and 1 live birth at term by cesarean delivery.

Conclusions: Our results demonstrate that ART preserves fertility and maintains excellent oncological outcomes with low complication rates.

Author Information

*First Clinic of Obstetrics and Gynecology, University of Medicine and Pharmacy of Târgu Mureş, Târgu Mureş; and †First Department of Oncologic Surgery, Gynecologic Oncology Unit, Regional Institute of Oncology, Iasi, Romania.

Address correspondence and reprint requests to Mihai Emil Căpîlna, MD, PhD, First Clinic of Obstetrics and Gynecology, University of Medicine and Pharmacy, str. Gheorghe Marinescu no. 50, 540136, Târgu-Mureş, Romania. E-mail: mcapilna@gmail.com.

The authors report disclosure of funding received for this work from any of the following organizations: National Institutes of Health, Wellcome Trust, Howard Hughes Medical Institute, and other(s).

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.

Received October 16, 2013

Accepted November 26, 2013

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.