Objectives To describe retrospectively our experience following abdominal radical trachelectomy (ART), including 5 performed during pregnancy, in terms of complications, obstetrical and oncologic outcomes.

Methods Between 2010 and 2020, all patients with early stage cervical cancer deserving to preserve their fertility were considered for ART. Out of the 19 patients who have met the inclusion criteria for ART, in 18 the trachelectomy was performed and only 1 case needed conversion to radical hysterectomy.

Results Patients‘ mean age was 31 years old (range 24- 38); two thirds of them were nulliparous. Six women (33.33%) were staged as IA2, 4 (22.22%) IB1, 5 (27.78%) IB2, and 4 (22.22%) stage IB3 disease. Only one intraoperative complication has occurred - both bladder and right ureteral injuries. Early postoperative complications were urinary bladder dysfunction (33.33%), symptomatic pelvic lymphocele which was drained (11.1%), peritonitis (5.5%), and wound infection (5.5%). Late postoperative complications included cervical stenosis (5.5%), amenorrhea (11.1%), and pelvic abscess (5.5%). Four out of the 18 patients were operated during pregnancy between 14 and 20 weeks; 2 of them have delivered at term, and 2 of them have aborted shortly after the surgery. One patients was operated immediately after caesarean section. Two vaginal recurrences were recorded; and both have been managed by hysterectomy, partial colpectomy and adjuvant chemoradiotherapy. At this moment, all patients are alive with no evidence of disease and 3 of them managed to conceive.

Conclusions ART is a reliable option as fertility sparring procedure. In selected cases, ART could be performed during pregnancy or after caesarean section with encouraging results.