Study Of Ovarian Function And Post-operational Sequelae Of Laparoscopic Lateral Ovarian Transposition In Cervical Cancer Patients.

Objective: To investigate the factors of influencing the ovarian function and the sequelae in yang women with early stage cervical squamous carcinoma who underwent radical hysterectomy, pelvic lymphadenectomy and LOT(lateral ovarian transposition), and the objective indicators of monitoring the ovarian function.Methods: 22 younger cervical squamous cancer patients (surgery age <45 years) including 19 cases who underwent radical hysterectomy, pelvic lymphadenectomy and LOT and 3 cases whose ovarian were retained in situ were recruited to our study. We used the Kupperman standard (1995) to investigate the climacteric syndrome of the patients and combined with FSH, LH, E2 and Inhibin B (INHB) to judge ovarian function. And we also used ultrasound to image the transposed ovaries to find out the sequela of LOT.Results: The female hormone levels and Kupperman score of 13 cases who underwent LOT had no difference before operation and after operation in six months(P>0.05). The level of FSH, LH, Kupperman score in LOT and postoperation radiotherapy group are higher than that in the no radiotherapy group (P<0.05), but were significantly higher than that whose ovarian were retained in situ(P<0.05).In 7 patients who accepted the surgery in 40-45 years old,2 patients had normal ovarian function,5 patients whose ovarian function were declined. In 12 patients who accepted the surgery less then 40 years old,9 patients had normal ovarian function,3 patients whose ovarian function were declined, in all the two groups there were not ovarian dysfunction cases, the rate of normal ovarian function between these two groups was no significant(P> 0.05) In the 19 LOT patients, no one whose tumour cell was spread, only one case had pelvic effusion, and disappeared after half of month by therapy, one had intermittent slight pain in the right position where the ovarian was transposed; .In the 22 cervical cancer patients received operation, with the decline of ovarian function, the level of INHB, E2 was declined, and the level of FSH was rose gradually; the different was significant between the group of normal ovarian function and that of declined ovarian function, as well as the group of normal ovarian function and that of ovarian dysfunction(P<0.05).Conclusion: LOT is effective in retaining the ovary functions of early stage cervical squamous carcinoma patients.Pelvic radiotherapy after LOT can greatly protect the ovary function, but it also partly damage the transposed ovarian. The patients more than 40 years old can also benefit from LOT. The rate of sequelae after LOT is very low. Just as FSH, INHB is also sensitive indicator that reflects ovarian function.