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Type II Versus Type III Fertility-Sparing Abdominal Radical Trachelectomy for Early-Stage Cervical Cancer: A Comparison of Feasibility of Surgical Outcomes
  1. Miho Muraji, MD*,
  2. Tamotsu Sudo, MD, PhD*,,
  3. Eriko Nakagawa, MD*,
  4. Sayaka Ueno, MD*,
  5. Senn Wakahashi, MD*,
  6. Seiji Kanayama, MD*,
  7. Takashi Yamada, MD*,
  8. Satoshi Yamaguchi, MD*,
  9. Kiyoshi Fujiwara, MD* and
  10. Ryuichiro Nishimura, MD*
  1. * Department of Gynecologic Oncology, and
  2. Section of Translational Research, Hyogo Cancer Center, Kita-Oji, Akashi, Japan.
  1. Address correspondence and reprint requests to Tamotsu Sudo, MD, PhD, Department of Gynecologic Oncology and Section of Translational Research, Hyogo Cancer Center, 13-70 Kita-Oji, Akashi 6738558, Japan. E-mail: reikeih{at}wine.ocn.ne.jp.

Abstract

Objective The purpose of this study was to compare surgical outcomes using modified (type II) and traditional (type III) abdominal radical trachelectomy (ART) for fertility-sparing surgery in early cervical cancer.

Methods A prospectively maintained database of ART procedures was analyzed. Data were collected regarding age, stage, histology, operative outcome, surgical complication, and fertility outcome.

Results We performed 23 fertility-sparing ARTs for patients with International Federation of Gynecology and Obstetrics stages IA to IB1 tumors of less than 2 cm between 2006 and 2010. Type III ART was attempted in 8 patients and modified ART in 15 patients. The median operating time was greater in the type III group compared with that in the type II group (305 vs 247 minutes; P < 0.02). The median surgical blood loss was greater in the type III ART group (580 mL; range, 250–988 mL) compared with that in the modified type II group (366 mL; range, 200–850 mL; P < 0.05). The median time to recovery of bladder dysfunction was less in the type II group (9 days; range, 3–10 days) than that in the type III group (13 days; range, 10–23 days; P < 0.01). There were no recurrences at the time of this report.

Conclusions Type II ART provides surgical and pathological outcomes with better recovery of bladder function similar to those in type III ART. For patients with early cervical cancer who wish to preserve reproductive function, type II ART is a feasible and safe operation.

  • Abdominal radical trachelectomy
  • Type II trachelectomy
  • Fertility sparing

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Footnotes

  • The authors declare that there are no conflicts of interest.

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