TITLE:
Radical Vaginal Hysterectomy and Trachelectomy in Early-Stage Cervical Cancer
AUTHORS:
Erasmo Bravo, Catalina Alonso Montemurro, Sergio Rojas Sepulveda, Jaime Cartagena Bustamante, Hector Pinto
KEYWORDS:
Radical Vaginal Hysterectomy, Radical Vaginal Trachelectomy, Early-Stage Cervical Cancer
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.8,
June
17,
2014
ABSTRACT: Objective: To communicate
a minimally invasive technique for surgical handling of early-stage cervical
cancer and its results. Methods: 110 patients with cervical cancer in stages
IA2 and IB1, all of them operated in a period of 5 years in both hospitals, are
presented. Laparoscopic systemic pelvic lymphadenectomy with radical vaginal
hysterectomy or radical vaginal trachelectomy was performed to patients, with
the exception of those patients who had compromised nodes detected in
contemporary biopsy. Results: Between April 2008 and May 2013, 110 patients
were submitted to this technique. 15 patients had their surgery aborted: 13
presented positive nodes for carcinoma in contemporary biopsy and 2 had
extensive cervical compromise when performing radical vaginal hysterectomy or
trachelectomy. Analysis of the remaining 95 cases shows an average age of 43.9
years (26 - 61), all of them had given birth before, 23 (21%) of them through
C-section. BMI averaged 30.5 and 31 (28.2%) had cone surgery performed
previously. Average duration of surgery was of 220 minutes. Postoperative
hospitalization averaged 3.1 days. Bleeding volume was estimated at 125 cc and
one patient required blood transfusion. En 25 patients’ uterine annexes were
kept and all of them were suspended by means of laparoscopy. On average, 25.4
pelvic nodes were obtained. Complications 13.6% with eight patients suffered
bladder injury, two had rectovaginal fistula, 3 patients requires surgical
repair of ureteral obstruction, two patients present thromboembolic disease.
The disease-free and overall survivals are consistent with reports in the
literature. Conclusion: We believe that handling patients with this technique
is possible and has the advantages of vaginal and laparoscopic surgery with
minimal complications.