Trachelectomy: How is it actually done? A review from FRANCOGYN group - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Journal of Gynecology Obstetrics and Human Reproduction Année : 2022

Trachelectomy: How is it actually done? A review from FRANCOGYN group

Trachélectomie: comment faire en pratique ? Revue de la littérature par le groupe FRANCOGYN

Résumé

Because of the peak incidence of cervical cancer between the ages of 35 and 44 and the increasing age of first pregnancy, the issue of fertility preservation in cases of early-stage cervical cancer in women in this reproductive age category arises. Early-stage cervical cancer patients have a good prognosis and are surgically treated in cases of mildly aggressive human papillomavirus-related histological type (squamous cell carcinoma, adenocarcinoma), FIGO stage IA to IB1 (i.e., <2 cm), with shallow stromal invasion (<10 mm) and without the presence of lymph-vascular space invasion or lymph node or regional involvement. Under these conditions, conservative treatment by trachelectomy, which has recurrence-free and overall survival rates equivalent to that of hysterectomy, may be considered. After a complete pre-therapeutic assessment, including pelvic lymphadenectomy, to eliminate all contraindications to conservative treatment, a simple or enlarged trachelectomy can be chosen. According to some authors, the route of entry (vaginal, simple or robot-assisted laparoscopy, laparotomy) has no significant effect on survival or fertility, although the literature on the subject is limited. Trachelectomy offers good results in terms of fertility, with an estimated pregnancy rate of between 23% and 55% and a live birth rate of 70%. The significant reduction of the cervix associated with the procedure increases the risk of prematurity. However, this can be prevented by the use of a permanent cerclage. Close follow-up of these patients is essential for a minimum period of 5 years in order to detect any recurrence or postoperative complications.
Fichier principal
Vignette du fichier
Lefebvre et al. - 2022 - Trachelectomy How is it actually done A review f.pdf (793.13 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)

Dates et versions

hal-03717184 , version 1 (21-07-2022)

Identifiants

Citer

A Lefebvre, Emilie Raimond, Pauline Chauvet, Cyril Touboul, Geoffroy Canlorbe, et al.. Trachelectomy: How is it actually done? A review from FRANCOGYN group. Journal of Gynecology Obstetrics and Human Reproduction, 2022, 51 (7), pp.102407. ⟨10.1016/j.jogoh.2022.102407⟩. ⟨hal-03717184⟩
126 Consultations
118 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More