The Clinical Study Of Radical Trachelectomy And Vagina Replacement By Peritoneum In The Treatment Of Early Stage Cervical Cancer

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 post vagina replacement by peritoneum.Methods:24 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, etc. were compared. For patients who received radical trachelectomy, the menstrual situation and pregnancy outcome post surgery were observed.Results:1. Intraoperative situation:all procedures were performed successfully. There was no significant difference between two groups in the operating time, blood lost, complications, lymph node number, and recovery post surgery.2. Postoperative situation:there was significant difference between two groups in the time of indwelling urinary canal. There was no significant difference between two groups in the hospitalization time, anal exhaust time post surgery, the incidence of lymophocyst. All patients were satisfied with their sexual activities.3. Recurrence:the two groups were followed up for 10 months to 5 years and there was no recurrent case.4. Pregnancy situation after radical trachelectomy:Normal menstruation was recovered post surgery in all patients with radical trachelectomy.13 patients contracepted actively. Pregnant rate was 45.45%(5/11), full term delivery rate (Caesarean section) was 9.09%(1/11). Pregnancy complications included miscarriage in the early and middle stage of pregnancy (18.18%,2/11) and premature delivery (18.18%,2/11)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 reserve the sexual quality.