Cervicectomy

The radical trachelectomy ( AltGr from. Τράχηλος trachelos "neck" and ectomy ) is a process developed by Daniel Dargent in 1994 surgical procedure for the surgical treatment of cervical cancer while preserving the fertility by leaving a portion of the cervix and uterine body.

Indications

The surgical method appears to be possible in patients with a potential desire for children, in which the sole cone biopsy is not sufficiently radical, but their complete removal of the uterus (hysterectomy ) or Wertheim operation overtreatment. This concerns regarding the extent of the tumor, the FIGO stages IA2 and IB1 with tumors < 2 cm, if it is in the tumor is a squamous cell carcinoma, the lymph nodes are free of tumor and the absence of other risk factors.

Principle

The procedure consists of the removal of about 2/3 of the cervix with roughly half of the parametrium. Subsequently, the sheath is adapted to the Zervixstumpf. In addition, a pelvic lymph node dissection is performed by laparoscopy.

Pregnancy after trachelectomy

The pregnancy rate varies between 40 and 70 percent. Due to the shortened cervix, there is a significantly increased risk of ascending infection and cervical weakness with risk of miscarriage or premature birth during pregnancy. For this reason, takes place in early / mid pregnancy a complete cervix closure. The delivery must be made by caesarean section.