LAPAROSCOPIC RADICAL TRACHELECTOMY: TECHNIQUE, FEASIBILITY AND OUTCOMES. EXPERIENCE HOSPITAL ITALIANO BUENOS AIRES, ARGENTINA

Abstract

Study Objective: Describe our surgical technique for laparoscopic radical trachelectomy, to evaluate its feasibility and show the perioperative results at Hospital Italiano of Buenos Aires, Argentine. Design: Retrospective study. Setting: Tertiay care teaching hospital Patients: 15 patients with early-stage cervical cancer and desire of fertillity sparing. Intervention: A review of a prospectively maintained database of all fertility-sparing radical laparoscopic trachelectomy procedures performed for early-stage cervical cancer between December 2011 and February 2016. Measurements and Main Results: We included 15 patients, in wich 14 of them underwent laparoscopic radical trachelectomy with pelvic lymphadenectomy for early-stage cervical cancer. 1 case was abort for positive lymph node in intraoperative frozen study. Histology included 4 cases (27%) with adenocarcinoma, 10 cases(67%) with squamous carcinoma and 1 case (6%) adenosquamous. Tumor stage was IA2 in 2 patients, IB in 12 patients, and IIA1 in one patient. The mean tumor size was 16.5 mm (range 7-30 mm). The mean age was 29 years old (range 19-39), the mean body mass index was 24 (r 18-48) and the mean length of hospital stay was 40 hours (range 24-72). The mean of operative time was 250 minutes (180-360) and no intraoperative complications were reported. In the 14 patients who completed the radical trachelectomy, pelvic and parametrial lymph nodes were negative. Median number of pelvic nodes evaluated was 16 (range, 10-25). No patient required conversion to laparotomy. Conclusion: We consider that laparoscopic radical trachelectomy, performed by trained surgeons, is a feasible and safe therapeutic option, as a fertility-sparing surgical technique, with good perioperative outcomes for women with early-stage cervical cancer with fertility desire. Minimally invasive surgery provides the widely known benefits of this type of approach.