Article Text
Abstract
Objectives Radical trachelectomy is the main surgical procedure in the treatment of invasive cervical cancer for patients who want to preserve fertility. Radical trachelectomy is not possible for some patients due to a large size of tumor which spreads onto the vagina or parametric, regional lymph nodes metastasis. These patients require radiation therapy, which excludes the possibility of independent pregnancy.
Methods We report 5 patients having stage Ib2-IIb cervical cancer. The average age is 29 years. At the first step of treatment, 2–3 courses of chemotherapy were carried out. The second step included a radical trachelectomy (Piver type III) with uterus transposition. The uterus blood supply was ensured by IP-ligaments, which are protruded approximately 15cm on each side. Due to this method, the uterus and ovary mobility was achieved. It made possible to paraumbilically transposition the uterus so that the conditions for performing radiotherapy were created. The third step marked a combined radiotherapy which was carried out according to the prescribed standards. In three months a uterine reposition with utero-vaginal anastomosis was conducted.
Results The patients have been under the median observation for 16,2 months so far. No one has any signs of recurrence. All our patients’ menses circles saved.
Conclusions The uterine transposition in treatment patients with stage Ib2-IIb cervical cancer ensures preservation of the uterus and ovarian function. This operation makes it feasible to provide a combined radiotherapy according to the prescribed standards and, thus, ensures, fertility preservation. Undoubtedly, that is very seminal to continue carrying out research in this field.