2011
DOI: 10.4103/0974-1216.85287
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Laparoscopic trachelectomy for cervical stump ′Carcinoma in situ′

Abstract: A 43-year-old, who underwent a subtotal hysterectomy for postpartum hemorrhage following a normal delivery, 10 years ago, presented with a history of persistent vaginal discharge and post-coital bleeding. A pap smear reported moderate dysplasia, and a subsequent colposcopic biopsy reported severe dysplasia with crypt extension. The patient underwent a laparoscopic trachelectomy, and histology of the stump reported cervical squamous carcinoma in situ, with no microinvasion.

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“…Of the present 9 cases treated with radical trachelectomy and pelvic lymphadenectomy (5 with laparoscopic; 4 with laparotomic abdominal surgery), only one patient experienced the complication of bladder fistula, and the patient recovered soon after reinserting the catheter. Compared with patients with cervical cancer and intact uteri, the patients with cervical stump cancer were generally older and typically had concurrent complicating conditions such as hypertension or diabetes (14)(15)(16)(17)(18)(19). The benefits of preserving the cervix may be associated with the patient's desire to preserve sexual, bladder and bowel function as previously reported, an approach that remains controversial among gynecologists (20)(21)(22).…”
Section: Discussionmentioning
confidence: 82%
“…Of the present 9 cases treated with radical trachelectomy and pelvic lymphadenectomy (5 with laparoscopic; 4 with laparotomic abdominal surgery), only one patient experienced the complication of bladder fistula, and the patient recovered soon after reinserting the catheter. Compared with patients with cervical cancer and intact uteri, the patients with cervical stump cancer were generally older and typically had concurrent complicating conditions such as hypertension or diabetes (14)(15)(16)(17)(18)(19). The benefits of preserving the cervix may be associated with the patient's desire to preserve sexual, bladder and bowel function as previously reported, an approach that remains controversial among gynecologists (20)(21)(22).…”
Section: Discussionmentioning
confidence: 82%
“…Trachelectomy is a notoriously difficult laparoscopic procedure ( 1 ). The reasons for this include remaining scar tissue from a prior supracervical hysterectomy, as well as the necessity to clear vital organs, including the bladder and the rectum out of the plane of dissection in order to remove the cervix ( 2 , 3 ).…”
Section: Introductionmentioning
confidence: 99%