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Abstract
Introduction. Among malignant neoplasms of the female reproductive system, cervical cancer (CC) is the leading cause of morbidity and mortality. Traditional surgical treatment of the early stages of CC leads to satisfactory oncological results, but irreversibly reduces the fertility of this group of patients. In recent years, a method of organ-preserving treatment such as radical trachelectomy (RT) has been actively introduced into clinical oncogynecological practice.
Aim. To evaluate reproductive and oncological outcomes in patients with invasive cervical cancer who underwent organ-sparing surgical treatment in the form of radical trachelectomy with reinforcement of the utero-vaginal anastomosis with a shape-memory titanium nickelide implant.
Materials and Methods. In 2010-2014, 168 patients with newly diagnosed invasive cervical cancer were treated with radical trachelectomy with reinforcement of the utero-vaginal anastomosis with a shape memory titanium nickelide implant at the Research Institute of Oncology of the Tomsk Scientific Research Center of the Russian Academy of Sciences and the Institute of Oncology and Neurosurgery of the Meshalkin National Medical Research Center. Oncological and reproductive outcomes were evaluated.
Results. Of the total number of patients, a total of 39 pregnancies were registered. Currently, 28 healthy babies have been born. Two patients gave birth twice, and one woman gave birth to twins. The median follow-up for this category of patients is 89 ± 9.6 months. Eight women had recurrences at different follow-up periods, localized mainly in the area of the anastomosis and the iliac vessels. Analysis of menstrual function showed that the duration of the menstrual cycle after surgical treatment with radical trachelectomy was 29 ± 4.7 days and did not differ significantly from the preoperative values. The duration of menstruation was also not significantly different before and after surgical treatment.
Conclusion. Improving the method of surgical organ-preserving treatment, such as radical trachelectomy, using technologies developed at the Tomsk Scientific Research Institute of Oncology, improves reproductive outcomes without reducing oncological efficiency.
References
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