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Abstract
Introduction Indications for a radical trachelectomy can be significantly expanded if an adjuvant concurrent chemoradiotherapy can be provided. These conditions can be achieved by the uterine transposition which must be done during the period of radiotherapy. When the radiation treatment is completed, the uterus can be repositioned back to the pelvic.
Methods Our research has included 11 patients with stage Ib1-IIb cervical cancer. Median of their age is 29 year old. At the first step of treatment, 2–3 courses of chemotherapy were carried out. At the second step radical trachelectomy (Piver type III) with uterine and ovarian transposition were done (photo 1). The oncological stages of operation corresponded to a routine radical trachelectomy. Paraumbilically uterine transposition created conditions for performing the radiotherapy. The third step included a concurrent chemoradiotherapy. On the next step of treatment uterine reposition with utero-vaginal anastomosis was conducted (photo 2). Today all the patients has no sign of recurrence and may start to realize the pregnancy.
Results The median observation is 23,4 months so far. All our patient’s menses have been recovered. No one has any signs of recurrence. Three of them are preparing to the in vitro fertilization.
Conclusion/Implications The uterine transposition enhanced limits of treatment for patients with stage Ib1-IIb cervical cancer and makes feasible to provide a radiotherapy according to the prescribed standards and, haven’t negative effect for ovarian function and menses. It is very important to continue and carrying out research which make possible to preserve fertility for patients with cancer.
