Incidence, risk factors and treatment of cervical stenosis after radical trachelectomy: A systematic review

Li, Xiaoqi; Jin, Li; Wu, Xiaohua

doi:10.1016/j.ejca.2015.05.012

Cited by 57 publications

(48 citation statements)

References 63 publications

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“…We concluded that, across the four studies, there was no association; stenosis occurred irrespective of whether cerclage was inserted. Cervical stenosis does not necessarily result in infertility, and may be avoidable, depending on the technique employed 6 24. The overall calculable infertility rate of 17.9% in motivated women is only marginally higher than in the general population,3 6 7 and this figure may have been affected by factors not applicable to this case, such as radiotherapy treatment.…”

Section: Discussionmentioning

confidence: 89%

Simple vaginal trachelectomy as a fertility-sparing treatment to manage high-grade dyskaryosis following multiple large loop excision of the transformation zone

2016

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SUMMARYA 34-year-old nullipara, wishing to start a family, presented to colposcopy clinic. Her most recent cervical cytology result showed high-grade dyskaryosis. Having undergone four large loop excisions of the transformation zone during the past 6 years, this woman had no remaining vaginal cervix. In order to excise presumed high-grade cervical intraepithelial neoplasia while mitigating obstetric risk, she underwent a simple vaginal trachelectomy and isthmic cerclage. 6 months later, the patient had a negative test of cure. 7 months following surgery she became pregnant naturally. At 29 weeks she had antenatal sepsis of unknown cause, which was treated with intravenous antibiotics. She delivered by caesarean section at 37 weeks and now has a healthy child. This report will discuss the obstetric impact of colposcopic treatment, and simple vaginal trachelectomy as a fertility-sparing treatment option for women who have had multiple loop excision procedures to treat premalignant lesions. BACKGROUND

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Section: Discussionmentioning

confidence: 89%

Simple vaginal trachelectomy as a fertility-sparing treatment to manage high-grade dyskaryosis following multiple large loop excision of the transformation zone

2016

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“…Another potential concern after radical trachelectomy is cervical stenosis. The rates of stenosis reported in the review by Li and colleagues , including more than 1500 patients ,11 was 11.0%, 8.1%, and 9.3 % for abdominal, vaginal, and laparoscopic radical trachelectomy , respectively. …”

Section: Case Presentationmentioning

confidence: 95%

Ovarian metastasis after laparoscopic radical trachelectomy

Noll

Saadi

Wernicke

et al. 2019

Int J Gynecol Cancer

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“…In this population, the shortened cervix and reduced amount of intracervical mucus facilitate the development of infection (chorioamnionitis), increasing the risk of premature labor. Moreover, cervical stenosis has been reported with an average incidence of 10.5% [23]. In such cases, another very important point has to be considered: for patients with IB1 tumors, negative LN and tumor size <2 cm, the risk of parametrial involvement varies between 0.4-0.6% [15,24].…”

Section: Surgical Approach Oncological and Fertility Outcomesmentioning

confidence: 99%

Conservative treatment in cervical cancer

Bergamini

Morice

2016

CBN

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Cervical cancer (CC) is increasingly being diagnosed in women of reproductive age, and fertility-sparing treatment has become an essential part of the therapeutic strategy for early stage CC (FIGO stage IA1-IB1). Conization is currently considered a safe and feasible treatment for stage IA1 CC without lymphovascular space invasion (LVSI). After the first report proposing vaginal radical trachelectomy (VRT) for the treatment of stage IB1 cervical tumors, several studies have evaluated vaginal, abdominal, and minimally-invasive approaches. Recent decades have been characterized by increased conservative treatment of more advanced tumors; in addition, several series assessing the oncological and obstetric outcomes of less radical surgery have been published. This review provides and overview of current evidence-based knowledge about the conservative management of CC, focusing on new perspectives and controversial issues.

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Incidence, risk factors and treatment of cervical stenosis after radical trachelectomy: A systematic review

Cited by 57 publications

References 63 publications

Simple vaginal trachelectomy as a fertility-sparing treatment to manage high-grade dyskaryosis following multiple large loop excision of the transformation zone

Simple vaginal trachelectomy as a fertility-sparing treatment to manage high-grade dyskaryosis following multiple large loop excision of the transformation zone

Ovarian metastasis after laparoscopic radical trachelectomy

Conservative treatment in cervical cancer

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