Abdominal radical trachelectomy: Success and pitfalls in a general gynecologic oncology practice

Olawaiye, Alexander; Carmen, Marcela del; Tambouret, Rosemary; Goodman, Annekathryn; Fuller, Arlan F.; Duska, Linda R.

doi:10.1016/j.ygyno.2008.10.029

Cited by 54 publications

(35 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These authors ignored cases in which menstrual flow continued to occur but os identification was difficult or impossible and thus underestimated the occurrence of cervical stenosis. Some authors [15,16,20] utilised much broader definitions; for example, including cases in which a standard endocervical brush could not be easily introduced into the os without mechanical dilation. These authors included clinically notable stenosis that did not require any intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Among the patients who did not have a cerclage placed, the incidence rate was 3.0% (2/66) (P = NS). Some authors hold the opinion that cerclage can increase erosion, infection and induce cervical stenosis [16][17][18]. Additionally, the technique used for cerclage placement, particularly if the stitch is placed too deeply into the cervical stroma, might increase the occurrence of cervical stenosis [13].…”

Section: Cerclagementioning

confidence: 99%

See 1 more Smart Citation

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

Jin

2015

European Journal of Cancer

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Cerclagementioning

confidence: 99%

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

Jin

2015

European Journal of Cancer

View full text Add to dashboard Cite

“…(9) Table I presents the oncological and pregnancy outcomes of patients reported to have undergone RAT in the literature. (2,(7)(8)(9)11,12) The laparoscopic or robotic approach to radical trachelectomy has recently been described to be associated with encouraging results in the medical literature. (13,14) Reports of less radical fertility-sparing surgeries for cervical cancer of FIGO stage IA2 to IB1, including conisation or simple trachelectomy with or without pelvic lymphadenectomy, have also recently been published.…”

Section: Discussionmentioning

confidence: 99%

Radical abdominal trachelectomy for stage IB1 cervical cancer in Singapore

Lim¹,

Chia²,

Quek³

et al. 2013

smedj

View full text Add to dashboard Cite

CA S E R EPO RTA 35-year-old woman with stage IB1 cervical cancer diagnosed on cone biopsy was referred to a colposcopy clinic for a Pap smear, which revealed adenocarcinoma in situ in July 2010.Colposcopy revealed a large ectropion with a focus in the posterior lip, which was suspicious for adenocarcinoma in situ.Laser cone biopsy was performed and histopathology revealed a well-differentiated adenocarcinoma of the cervix measuring 16 mm × 14 mm. The radial margins were involved, but there was no lymphovascular space involvement. Chest radiography and magnetic resonance imaging of the abdomen and pelvis did not reveal any distant metastases. The patient shared her desire to retain fertility as she did not have any children.She was appropriately counselled, and subsequently consented to undergo RAT and bilateral pelvic lymphadenectomy in August 2010.RAT was performed based on the technique described by Abu-Rustum et al, (2) with some modifications (Figs. 1a-e).The procedure was carried out through a Maylard incision.Development of the obturator, paravesical and pararectal spaces was carried out, followed by systematic bilateral pelvic lymphadenectomy. The patient's pelvic lymph nodes, which were sent for histological frozen sectioning, were negative for malignancy. Next, the urinary bladder was mobilised down to the mid-vagina. The infundibulopelvic ligaments, which contain the ovarian vessels, were kept intact. A uterine clamp was used to manipulate the uterus and avoid damage to the fallopian tubes and ovarian vessels. The uterine arteries were ligated at its origin from the internal iliac arteries. The pouch of Douglas was entered and the uterosacral ligaments were taken. Both ureters were mobilised down to the base of the bladder before the parametrium could be taken. The vagina was entered with the aid of a LiNA McCartneyTube TM (LiNA Medical, Devon, UK). A vaginal cuff of 2 cm was taken. Clamps were then placed at the level of the internal os and the cervix was amputated at about 5 mm below the level of the internal cervical os. A shaved margin of the remaining endocervix was sent for frozen sectioning to determine the resection margins. Once the margins were revealed to be negative for malignancy on histopathology, a permanent cerclage was placed using Ethibond™ #0 suture (Ethicon Inc, NJ, USA)

show abstract

“…Based on mathematical models of the decline of the antibody over the years, boosters may not be needed for at least 20 years. Since registration data was based on efficacy trials in [16][17][18][19][20][21][22][23][24][25][26] years of age and bridging immunological response study of adolescence, efficacy on adult women was performed for data in supporting registration up to 45 years of age. 12,16 The quadrivalent vaccine trial in 24-45 year old women showed 83% efficacy in preventing persistent infection, CIN or external genital lesion (EGL).…”

Section: Update On Hpv Vaccination Hextan Y S Nganmentioning

confidence: 99%

“…Experience with RAT has been limited in comparison to RVT, but does offer another fertility-sparing option for young women with cervical cancer. 26 The similar approach of this technique to RH makes it more accessible to surgeons who are not well trained with radical vaginal surgery, and additionally can be used with larger tumors, or with vaginal anatomy that prohibits the applicability of the RVT. 27 Neoadjuvant chemotherapy (NACT) can reduce the tumor size prior to fertility-sparing surgery.…”

mentioning

confidence: 99%

Asian society of gynecologic oncology workshop 2010

et al. 2010

View full text Add to dashboard Cite

and was organized to promote the academic environment and to enhance the communication among Asian countries prior to the 2nd biennial meeting of Australian Society of Gynaecologic Oncologists (ASGO), which will be held on November 3-5, 2011. We summarized the whole contents presented at the workshop. Regarding cervical cancer screening in Asia, particularly in low resource settings, and an update on human papillomavirus (HPV) vaccination was described for prevention and radical surgery overview, fertility sparing and less radical surgery, nerve sparing radical surgery and primary chemoradiotherapy in locally advanced cervical cancer, were discussed for management. As to surgical techniques, nerve sparing radical hysterectomy, optimal staging in early ovarian cancer, laparoscopic radical hysterectomy, one-port surgery and robotic surgery were introduced. After three topics of endometrial cancer, laparoscopic surgery versus open surgery, role of lymphadenectomy and fertility sparing treatment, there was a special additional time for clinical trials in Asia. Finally, chemotherapy including neo-adjuvant chemotherapy, optimal surgical management, and the basis of targeted therapy in ovarian cancer were presented.

show abstract

Abdominal radical trachelectomy: Success and pitfalls in a general gynecologic oncology practice

Cited by 54 publications

References 31 publications

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

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

Radical abdominal trachelectomy for stage IB1 cervical cancer in Singapore

Asian society of gynecologic oncology workshop 2010

Contact Info

Product

Resources

About