The clinical study of radical trachelectomy and vagina replacement by peritoneum in the treatment of early stage cervical cancer

Abstract

Objective To compare the clinical results of radical trachelectomy and radical hysterectomy in treating patients with early stage cervical cancer and to evaluate the feasibility and security of radical trachelectomy and the sexual quality after vagina replacement by peritoneum. Methods Twenty-four women with early stage cervical cancer( IA2-IB1 ) were performed laparoscopic pelvic lymphadenectomy + radical trachelectomy + vagina replacement by peritoneum, and 32 women with early stage cervical cancer as control were performed laparoscopic pelvic lymphadenectomy + radical hysterectomy + vagina replacement by peritoneum. The operating time, blood lost, complications, recovery post surgery,recurrent rate and sexual quality were compared. For patients who received radical trachelectomy, the menstrual situation and pregnancy outcome post surgery were observed. Results All procedures were performed successfully. There was no significant difference between the two groups in the operating time, blood lost, complications, lymph node number or recovery post surgery ( P ＞ 0. 05 ). Normal menstruation was recovered post surgery in all patients with radical trachelectomy. Pregnant rate was 45.45 % (5/11), full term delivery rate(Caesarean section) was 9.09% (1/11), miscarriage rate was 18.18% (2/11) ,and premature delivery rate was 18.18% (2/11). The two groups were followed up for 10 months to 5 years. There was no recurrent case and all patients were satisfied with their sexual activities. Conclusions Radical trachelectomy and radical hysterectomy have the same treating results for early stage cervical cancer. To prolong the vagina with peritoneum during the procedures can improve the sexual quality. Radical trachelectomy and vagina replacement by peritoneum is a selective treating strategy for patients with early stage cervical cancer who desire to preserve fertility and physiological function. Key words: Radical trachelectomy; Vagina replacement by peritoneum; Early stage cervical cancer; Preserve fertility and physiological function