ANALYSIS OF 79 CASES OF TRANSVAGINAL EXTERNAL FASCIA TRACHELECTOMY
Objectives To explore the feasibility and safety about the surgery__transvaginal external fascia trachelectomy to conservatively treat stage Ial squamous carcinoma of the cervix (SCC) and cervical intraepithelial neoplasia(CIN) III thats not suitable to take cold knife conization(CKC). Methods From July 2002 to April 2011, those patients who have a strong desire to salvage uterine or fertility but also are confronted with following situations received transvaginal external fascia trachelectomy, CIN III with large lesion (colposcopically observed lesion is larger than 3/4 of the cervix), or patients with CIN II-III suffered recurrence or had persistent lesion or positive margin after CKC or LEEP, or patients with CIN II- III upgraded into stage Ial SCC through LEEP and pathological confirmation (except for those with lymphovascular space invasion), or CIN III patients complicated with upper vaginal intraepithelial neoplasia(VAIN), Their clinical information and data were reviewed and analyzed. Results 83 patients took this surgery successfully but 4 of them exited this research in that they upgraded into stage Ibl SCC after postoperative pathological confirmation. In the remaining 79 cases, 6 are stage Ial SCC, 61 are CIN III with a large lesion (23 cases are glandulous involvement), 3 are CIN III complicated with VAIN, 6 are CIN III with persistent lesion after LEEP and 2 are CIN III with positive margins after LEEP. The median age of these patients is 33y, ranging from 23 to 40. The mean operation time is 39min (rang 2060min), the average amount of bleeding is 40ml (rang 1 -300ml) and the mean hospital stay is 10d( rang 617d). The median follow-up time is 49m(8-85m) and none of these patients has large amount of intraoperative or post-operative hemorrhage or postoperative recurrence. No one complains any effect on sexual life. Among the 5 patients with reproductive desire, one is in her 22w gestation after one induced abortion and one spontaneous abortion, 4 patients experienced term birth in which three are cesarean section and one is natural labour. Conclusions Transvaginal external fascia trachelectomy is a safe and effective treatment for stage Ial SCC, CIN III with large lesion, CIN III complicated with VAIN and CIN II-III suffering recurrence, persistent lesion or positive margins after CKC and others that are not suitable to take CKC.
Cervical tumor CIN Cervix Genealogical surgery
Zeng Si-yuan Li Long-yu Liang Mei-wng Zhong Mei-ling
Department of Oncology, Maternal and Child Health Hospital of Jiangxi Province, Nanchang 330006, China
国际会议
亚太地区国际肿瘤生物学和医学学术会议、全国肿瘤标志学术大会、第六届中国中青年肿瘤专家论坛
上海
英文
260-268
2011-10-13（万方平台首次上网日期，不代表论文的发表时间）