Skip Navigation LinksHome > March 2014 - Volume 24 - Issue 3 > Abdominal Radical Trachelectomy: A Romanian Series
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International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0000000000000076
Surgeons Corner

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*

Open Access
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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.

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

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