scholarly journals Radical Vaginal Trachelectomy

2021 ◽  
Author(s):  
Tsuyoshi Saito ◽  
Motoki Matsuura ◽  
Masato Tamate ◽  
Masahiro Iwasaki ◽  
Tasuku Mariya

AbstractRecently, radical vaginal hysterectomy (RVH) has developed into laparoscopically assisted radical vaginal hysterectomy (LARVH), which is associated with the laparoscopical procedure, and it is applied as radical vaginal trachelectomy and semi-radical vaginal hysterectomy. LARVH is indicated for patients with stage IB1 and IIA1 cervical carcinoma, especially those with a tumor size of less than 2 cm, because the cardinal ligaments cannot be resected widely. Although RVH that is associated with laparoscopic pelvic lymphadenectomy is the most used surgical procedure, radical trachelectomy may be performed either abdominally or vaginally (laparoscopic or robotic). One report found that the pregnancy rate was higher in patients who underwent minimally invasive or radical vaginal trachelectomy than in those who underwent radical abdominal trachelectomy.

2011 ◽  
Vol 21 (1) ◽  
pp. 137-140 ◽  
Author(s):  
Piksi Singh ◽  
James Nicklin ◽  
Timothy Hassall

Background:Clear cell adenocarcinoma of the cervix (CCAC) may affect pediatric and younger women in absence of diethylstilbestrol exposure and other classic predisposing factors for cervical cancer. Prognosis is similar for early-stage CCAC, squamous cell cancer and non-clear cell adenocarcinoma of the cervix. Vaginal radical trachelectomy (VRT) and abdominal radical trachelectomy (ART) with pelvic lymph node dissection have evolved as valuable fertility-preserving treatment options. Neoadjuvant chemotherapy (NACT) before abdominal radical trachelectomy/VRT may reduce tumor size and thereby facilitate surgery. In some cases, adjuvant treatment in the presence of high-risk prognostic features may be required to optimize treatment.Methods:A 13-year-old adolescent with International Federation of Obstetrics and Gynecology stage IB1 CCAC was treated with NACT using carboplatin and paclitaxel (CP) followed by laparoscopic pelvic lymphadenectomy, VRT, and adjuvant chemotherapy.Results:Neoadjuvant chemotherapy using CP was well tolerated with no toxicity. Neoadjuvant chemotherapy reduced the tumor size and facilitated radical vaginal trachelectomy. Adjuvant treatment was recommended in the presence of risk factors. The patient elected to conserve the uterus and underwent 3 further cycles of adjuvant chemotherapy with CP.Conclusions:This is the first reported case of CCAC treated with NACT using CP followed by laparoscopic pelvic lymphadenectomy, VRT, and adjuvant chemotherapy. A successful treatment outcome achieved using this novel approach suggests its applicability in selected cases.


2018 ◽  
Vol 17 (5) ◽  
pp. 106-110
Author(s):  
S. A. Skugarev ◽  
Е. G. Novikova ◽  
A. S. Shevchyuk

The purpose of the studywas to review available data on various techniques for radical trachelectomy, inclusion criteria, advantages and disadvantages.Material and methods.A systematic literature search was conducted in the electronic databases of Medline, Russian Science Citation Index, and Russian State Library in the interval time between 1997 and 2017.Results.To date, only radical trachelectomy has shown its value regarding both aspects of oncologic and reproductive outcomes in patients with invasive cervical cancer. There are currently 5 approaches to radical trachelectomy: transvaginal approach with laparoscopic pelvic lymphadenectomy, abdominal, laparoscopic, robot-assisted and laparoscopic – vaginal approach. Each technique has its advantages and disadvantages.Conclusion.Over the last years, radical trachelectomy has been recognized as a valuable fertility-preserving option for women of child-bearing age with invasive cervical cancer. Radical trachelectomy should be performed by highly skilled surgeons in specialized clinics.


Author(s):  
Dimitrios Nasioudis ◽  
Benjamin B. Albright ◽  
Ashley F. Haggerty ◽  
Emily M. Ko ◽  
Sarah H. Kim ◽  
...  

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