Introduction/Background Radical Hysterectomy with pelvic lymph node dissection is to date, the standard Treatment for early-stage cervical cancer (Ia2-Ib1).
However in some cases of women at reproductive age with early-stage disease, a less radical procedure without removing of the corpus, such as a radical trachelectomy can present an oncologic safe approach. This includes patients without risk factors (G1-2, L0, V0, <2 cm in diameter tumours).
Methodology We present a 36-year-old woman gravid 0, stage IA2 cervical cancer, without risk factors, squamous, wishing to preserve fertility. Patient received intraoperatively an intracervical injection of technetium-99m colloidal albumin as well as blue dye to identify the pelvic sentinel nodes.
She underwent a laparoscopic radical trachelectomy with bilateral dissection of the pelvic sentinel lymph nodes. Additionally we performed cervical cerclage laparoscopically.
Results Operation time was 181 minutes, and the estimated blood loss was 100 ml. There were no intraoperative or postoperative complications. The final pathology reported a tumour of 7 mm with infiltration of 4 mm, surgical margins without injury, and 4 pelvic nodes without tumour. After a 12 month follow-up, the patient is having regular periods, but has not yet tried to get pregnant. No evidence of recurrence.
Conclusion Laparoscopic radical trachelectomy and bilateral pelvic sentinel node dissection is a safe alternative in young patients who wish to preserve fertility with early stage cervical cancer without risk factors and tumor diameter smaller than 2 cm.
Additionally a cervical cerclage should be offered at the same procedure in order to minimise the risks for obstetric complications later.
Disclosure Nothing to disclose.
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