Radical trachelectomy: a 10-year experience of Tomsk Cancer Research Institute
The article summarizes and presents 10 years of experience in the organ-preserving treatment of invasive cervical cancer in patients of reproductive age in the amount of radical trachelectomy. The study included 68 patients with cervical cancer (T1a1NxM0 - T2aNxM0), the average age was 34.1 ± 8.4 years. Of these, 39 patients underwent radical trachelectomy with transabdominal access, 29 - with laparoscopic. During the operation, a mesh implant with a shape memory, woven into a stocking of super-elastic nickel-titanium filament with subsequent fixation with separate sutures along the perimeter, was used to form the locking apparatus of the uterus and strengthen the utero-vaginal anastomosis. It has been shown to be highly effective for providing a “locking” effect of the cervix. Of all the patients treated, 15 (22%) spontaneous pregnancies were registered, 9 after PAT and 6 after RT with laparoscopic access, of which 3 had operative delivery in terms of 29, 31 and 38 weeks. one currently has a prolongation of pregnancy (33 weeks), 2 (13.3%) had spontaneous miscarriages, the rest interrupted the pregnancy for various reasons. The onset of pregnancy was noted in patients after laparoscopic RT within a shorter period after surgery from 3 to 18 months. Menstrual dysfunction after surgery was observed in 4% and 19%, respectively. Dysfunctional uterine bleeding prevailed. The median follow-up was 69 months; 1 relapse was detected (1.4%). Overall survival rate of 100%.