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Peltecu G. Eugen Bogdan Aburel, a pioneer of fertility sparing surgery. Gynecol Oncol 2024; 181:40-45. [PMID: 38104528 DOI: 10.1016/j.ygyno.2023.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 10/31/2023] [Indexed: 12/19/2023]
Abstract
Eugen Bogdan Aburel was pioneer of the fertility sparing surgery in early cervical cancer in young women desiring to preserve their childbearing potential. He graduated in Romania but started specializing in obstetrics and gynecology in Paris, where he had the chance to work with the most prominent professors of the time and do research at Sorbonne, the most famous French higher education institution. Most of his discoveries date from the time he spent in Paris hospitals, proving that a good medical school can generate remarkable physicians. The fertility sparing surgery he created after returning to Romania did not have the same chance to be known and spread to the international medical world because of the Cold War isolation, Romania belonging to the Eastern Communist bloc. However, his pioneering work in this field of surgery is fully recognized today.
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Affiliation(s)
- Gheorghe Peltecu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Obstetrics and Gynecology, Filantropia Hospital, Bucharest, Romania.
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Shima E, Itsukaichi M, Yoshihara K, Ishiguro T, Haino K, Nishino K, Nishikawa N, Nishijima K, Enomoto T. Fetal biometric and Doppler measurements following abdominal radical trachelectomy in the second trimester of the pregnancy. BMC Pregnancy Childbirth 2022; 22:343. [PMID: 35443666 PMCID: PMC9022245 DOI: 10.1186/s12884-022-04671-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Our previous study demonstrated the safety and effectiveness of abdominal radical trachelectomy during pregnancy but did not focus on the fetus. This study aimed to clarify the influence of abdominal radical trachelectomy performed during pregnancy on the fetus. METHODS Eight cervical cancer patients who underwent abdominal radical trachelectomy at our hospital between February 2013 and August 2020 were enrolled in this study. To assess the peri- and postoperative influence on the fetus, we performed fetal heart monitoring at 30-min intervals during abdominal radical trachelectomy and calculated the estimated fetal body weight and resistance indexes of the middle cerebral artery and umbilical artery from postsurgery until delivery. RESULTS Four out of eight patients had preterm birth due to chorioamnionitis in one case and consideration of the recurrent risk of cervical cancer in three cases. Fetal heart monitoring during abdominal radical trachelectomy revealed deceleration just once in one case but no abnormal findings in the other cases. In all cases, the fetal growth after abdominal radical trachelectomy was normal until delivery. No abnormal Doppler findings were detected in the middle cerebral artery or umbilical artery. CONCLUSION Our findings clarified that abdominal radical trachelectomy performed for the treatment of early-stage cervical cancer during pregnancy has no obvious influence on fetal growth. Next, it is necessary to evaluate the growth and development of children delivered from mothers who have undergone abdominal radical trachelectomy during pregnancy.
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Affiliation(s)
- Eiri Shima
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan
| | - Mina Itsukaichi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan
| | - Kosuke Yoshihara
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan
| | - Tatsuya Ishiguro
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan
| | - Kazufumi Haino
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan
| | - Koji Nishino
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan
| | - Nobumichi Nishikawa
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan
| | - Koji Nishijima
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan.
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Yoshino AI, Kobayashi E, Kodama M, Hashimoto K, Ueda Y, Sawada K, Tomimatsu T, Kimura T. Oncological and Reproductive Outcomes of Abdominal Radical Trachelectomy. Anticancer Res 2020; 40:5939-5947. [PMID: 32988926 DOI: 10.21873/anticanres.14615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/07/2020] [Accepted: 07/17/2020] [Indexed: 11/10/2022]
Abstract
Background/Aim: There is an increasing demand for preserving the fertility of young women impacted with early-stage cervical cancer. The aim of this study is to evaluate the oncological and reproductive outcomes of abdominal radical trachelectomy (ART). Patients and Methods: We retrospectively reviewed patients with FIGO stageIA2-IB1 cervical cancer who underwent ART from 2007 to 2018. We also compared the oncological prognosis between the patients who underwent ART and radical hysterectomy (RH). Results: A total of 42 patients underwent ART. During median follow-up 62.5 months, there were 4 (9.5%) recurrences and 1 (2.4%) death. As for tumors ≤2 cm, the 5-year recurrence-free survival (RFS) rate and overall survival (OS) rate for patients who underwent ART was similar to those who underwent RH (89.8% vs. 92.7%, p=0.42 and 97.3% vs. 95.0%, p=0.44, respectively). Nineteen patients attempted to conceive and seven of them were successful. There was one case of a first-trimester miscarriage, two cases of preterm delivery, three cases of full-term delivery and one ongoing pregnancy. Conclusion: ART could be a feasible alternative to RH for patients with tumors ≤2 cm with comparable oncological outcome.
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Affiliation(s)
- A I Yoshino
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eiji Kobayashi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Michiko Kodama
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kae Hashimoto
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kenjiro Sawada
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takuji Tomimatsu
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
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Wang Y, Peng Y, Lin Z, Yao T. The safety and effectiveness of preserving the ascending uterine artery in a modified fertility-sparing abdominal radical trachelectomy. Eur J Obstet Gynecol Reprod Biol 2020; 252:193-197. [PMID: 32623251 DOI: 10.1016/j.ejogrb.2020.06.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the outcome of preserving the ascending uterine artery in a modified fertility-sparing abdominal radical trachelectomy and understand whether preserving uterine arteries during abdominal radical trachelectomy is helpful for patients. METHODS From September 2005 to September 2019, 31 early uterine cervical cancer patients who underwent modified fertility-sparing abdominal radical trachelectomy were enrolled in this study, and were followed up in our cancer center. Computed tomography (CT) of the abdomen and pelvis was advised as the initial investigation to evaluate the ascending uterine artery in 11 patients. The major outcomes were recurrence, mortality, CT results and obstetric outcomes. RESULTS During the median follow-up of 56 months, two recurrences were recorded. Among 11 patients who underwent CT, none of them showed uterine arteries occlusion. Fifteen patients attempted to conceive, and 5 pregnancies were achieved in 5 patients. Hence, the pregnancy rate among patients who attempted to conceive was 33.3 %. There was only one artificial first-trimester abortion. Three pregnancies resulted in live births, and two of them got full-term births. CONCLUSIONS The modified fertility-sparing abdominal radical trachelectomy in preserving uterine arteries is effective, and it is recommended that surgeon should retain the uterine artery as much as possible during operation.
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Affiliation(s)
- Yuhan Wang
- Department of Gynecological Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, China
| | - Yongpai Peng
- Department of Gynecological Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, China
| | - Zhongqiu Lin
- Department of Gynecological Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, China
| | - Tingting Yao
- Department of Gynecological Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, China; Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes, Sun Yat-sen University, Guangzhou, China.
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Prodromidou A, Iavazzo C, Fotiou A, Psomiadou V, Douligeris A, Vorgias G, Kalinoglou N. Short- and long term outcomes after abdominal radical trachelectomy versus radical hysterectomy for early stage cervical cancer: a systematic review of the literature and meta-analysis. Arch Gynecol Obstet 2019; 300:25-31. [PMID: 31062151 DOI: 10.1007/s00404-019-05176-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 04/24/2019] [Indexed: 12/09/2022]
Abstract
PURPOSE Cervical cancer (CC) ranks 2nd for mortality among women of reproductive age in the United States. Abdominal radical trachelectomy (ART) is a fertility sparing approach that has been proposed in women with early stage CC who wish to preserve their fertility. The aim of the present meta-analysis was to evaluate the short- and long-term outcomes of RH vs ART for early stage CC. METHODS A total of 5 electronic databases were searched for articles published up to December 2018. Prospective and retrospective trials reporting outcomes for women who underwent ART or RH for the management of early stages CC, were considered eligible for inclusion. Statistical meta-analysis was performed using the RevMan 5.3 software. RESULTS A total of 5 studies which included 840 women who underwent ART or radical trachelectomy (RH) were included in the present meta-analysis. Among them, 324 underwent ART whereas the remaining 516 had RH. Despite the fact that ART was associated with significantly prolonged operative time compared to RH (840 patients MD 36.82 min, 95% CI 20.15-53.49, p < 0.001), neither 5-year OS nor 5-year DFS were different among the two groups (714 patients OR 1.39, 95% CI 0.53-3.62, p = 0.51 and 682 patients OR 1.08, 95% CI 0.52-2.25, p = 0.84, respectively). CONCLUSIONS ART is a more complex and time consuming technique, but equally safe compared to RH in terms of oncological outcomes for selected women with early stage CC and allows for more CC survivors of childbearing age to preserve their fertility.
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Affiliation(s)
- Anastasia Prodromidou
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece.
- Department of Surgical Oncology, Metaxa Memorial Anticancer Hospital, Mpotasi 51, Piraeus, Greece.
| | - Christos Iavazzo
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Alexandros Fotiou
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Victoria Psomiadou
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Athanasios Douligeris
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Georgios Vorgias
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
| | - Nikolaos Kalinoglou
- Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece
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Li X, Li J, Jiang Z, Xia L, Ju X, Chen X, Wu X. Oncological results and recurrent risk factors following abdominal radical trachelectomy: an updated series of 333 patients. BJOG 2019; 126:1169-1174. [PMID: 30663205 DOI: 10.1111/1471-0528.15621] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To update the oncological results and identify recurrent risk factors in young patients with early stage cervical cancers following abdominal radical trachelectomy (ART). DESIGN Retrospective study. SETTING A university-based cancer hospital. POPULATION Three hundred and thirty-three patients. METHODS We conducted a retrospective analysis from a prospectively maintained database of patients undergoing ART from April 2004 to December 2017. MAIN OUTCOME MEASURES Survival rate, clinicopathological factors related to recurrences. RESULTS Two hundred and seventy-one patients had squamous carcinomas (SCC), 51 had pure adenocarcinomas (AC), and 11 had adenosquamous carcinomas (AS). One hundred thirty-two women (39.6%) had tumours ≥2 cm. With a median follow up of 56 months (range, 6-169), 11 patients (3.3%) had recurrence, and five patients (1.5%) died. The cumulative 5-year recurrence-free survival and overall survival rates were 96.3 and 98.6%, respectively. The recurrence rate in women with tumours ≥2 cm was comparable to that in patients with tumours <2 cm (5.3 versus 2.0%, respectively, P = NS). However, the recurrence rate was significantly higher in patients with AS histology than those with AC and SCC histology (18.2, 3.9, and 2.6%, respectively, P < 0.05). All of the recurrent patients with AS histology had tumours ≥2 cm. Multivariate analysis showed that the only independent risk factor for recurrence was histology type. CONCLUSIONS This updated series showed a favourable survival rate following ART. These results further supported that ART was a safe option for well-selected patients with stage IB1 cervical cancers ≥2 cm. However, if patients with tumours ≥2 cm have AS histology, they should be advised with great caution when contemplating ART. TWEETABLE ABSTRACT Abdominal radical trachelectomy could be a safe, fertility-sparing option for strictly selected patients with stage IA1-IB1 cervical cancers ≤4 cm.
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Affiliation(s)
- X Li
- Department of Gynaecologic Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - J Li
- Department of Gynaecologic Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Z Jiang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Radiology, Fudan University Shanghai Cancer Centre, Shanghai, China
| | - L Xia
- Department of Gynaecologic Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - X Ju
- Department of Gynaecologic Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - X Chen
- Department of Gynaecologic Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - X Wu
- Department of Gynaecologic Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Kasuga Y, Miyakoshi K, Nishio H, Akiba Y, Otani T, Fukutake M, Ikenoue S, Ochiai D, Matsumoto T, Tanaka K, Minegishi K, Kuji N, Roberts R, Aoki D, Tanaka M. Mid-trimester residual cervical length and the risk of preterm birth in pregnancies after abdominal radical trachelectomy: a retrospective analysis. BJOG 2017; 124:1729-1735. [PMID: 28418597 DOI: 10.1111/1471-0528.14688] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the association between mid-trimester residual cervical length (CL) and the risk of preterm birth in pregnancies after abdominal radical trachelectomy (RT). DESIGN Retrospective cohort study. SETTING University hospital. POPULATION A total of 33 deliveries after 22 weeks' gestation in 30 women who underwent abdominal RT including prophylactic cervical cerclage and perinatal care between January 2002 and May 2016. METHODS The association between mid-trimester residual CL (the distance between the cerclage and the external cervical os) and gestational age at delivery was investigated. Receiver-operating characteristics (ROC) curve analysis was performed to estimate the optimal cut-off values of the mid-trimester residual CL for the prediction of preterm birth. MAIN OUTCOME MEASURES Preterm birth before 34 weeks' gestation. RESULTS Mid-trimester residual CL showed a significant correlation with gestational age at delivery (r = 0.36, P < 0.05). There was a significant difference in residual CL between women who did and those who did not give birth before 34 weeks (P < 0.05). Mid-trimester residual CL < 13 mm was a good predictor of birth before 34 weeks, with a sensitivity of 67%, specificity of 75%, positive predictive value of 55% and negative predictive value of 86% (area under ROC curve, 0.75). CONCLUSIONS Mid-trimester residual CL is significantly correlated with gestational age at delivery. Residual CL assessment could be used to reassure physicians and women that there is only a small chance of preterm birth in pregnancies after abdominal RT. TWEETABLE ABSTRACT Mid-trimester residual cervical length is a good predictor of preterm birth after radical trachelectomy.
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Affiliation(s)
- Y Kasuga
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - K Miyakoshi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - H Nishio
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Y Akiba
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - T Otani
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - M Fukutake
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - S Ikenoue
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - D Ochiai
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - T Matsumoto
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - K Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | | | - N Kuji
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - R Roberts
- Center for Clinical Research, Keio University School of Medicine, Tokyo, Japan
| | - D Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - M Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
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Terukina J, Takamatsu M, Enomoto T, Baba H. Anesthetic management of abdominal radical trachelectomy for uterine cervical cancer during pregnancy. J Anesth 2017; 31:467-471. [PMID: 28238025 DOI: 10.1007/s00540-017-2325-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 02/13/2017] [Indexed: 01/24/2023]
Abstract
Abdominal radical trachelectomy has been identified as a surgical option for fertility preservation in cervical cancer patients, particularly in pregnant women who strongly desire to continue their pregnancy. Since this procedure requires operating in the uterus, the hardness of the uterus can affect the ease of surgery. Generally, sevoflurane is used for anesthesia in non-obstetric surgery for pregnant women because uterine relaxation is advantageous for uterine blood flow maintenance. However, the use of sevoflurane during radical trachelectomy has not been thoroughly evaluated. Here, we report on anesthesia use in three cases of abdominal radical trachelectomy during pregnancy. Propofol enabled maintenance of uterine tension while not significantly affecting fetal growth. It is important to consider maintenance of uterine tension and fetal circulation in anesthesia management. During the operation, we performed an ultrasound examination every 30 min to confirm fetal well-being. Although frequent fetal heart rate monitoring of the pre-viable fetus is not recommended, if fetal bradycardia is detected, sevoflurane may then be used to improve fetal circulation. Additionally, if the fetal heartbeat stops, a radical hysterectomy would then be required. Therefore, we consider that fetal heart rate monitoring during this procedure is necessary, and propofol is suitable as an anesthetic for this surgery during pregnancy.
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Affiliation(s)
- Jun Terukina
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Misako Takamatsu
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan.
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroshi Baba
- Department of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Hanada T, Tsuji N, Miyata H, Kadogami D, Seo K, Deguchi M, Yamamoto R, Butsuhara Y, Jimi T, Kozono Y, Iwami S, Terakawa K, Nagano T. Successful delivery after abdominal radical trachelectomy followed by adjuvant chemotherapy for advanced invasive uterine cervical cancer: a case report and literature review. Int Cancer Conf J 2015; 5:9-12. [PMID: 31149415 DOI: 10.1007/s13691-015-0215-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 03/23/2015] [Indexed: 11/24/2022] Open
Abstract
Uterine cervical cancer is increasingly prevalent among young Japanese women who are eager to preserve their fertility, and abdominal radical trachelectomy (ART) is often performed in patients with early-stage invasive lesions. Herein we present details of a 27-year-old woman with stage IB1 cervical cancer. Although the patient received ART, histopathological findings revealed a parametrial invasion. Hence, 3 courses of adjuvant chemotherapy with paclitaxel and carboplatin (TC) were administered, and the patient conceived spontaneously 44 months later. Rupture of the membrane occurred at 32 weeks and 4 days, and a 1822 g female baby was delivered by emergency cesarean section. The patient is alive without disease and her child is growing favorably. This case demonstrates the balance between preservation of fertility and curative adjuvant chemotherapy after ART.
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Affiliation(s)
- Tetsuro Hanada
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Natsuki Tsuji
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Hiromi Miyata
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Daisuke Kadogami
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Koji Seo
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Mari Deguchi
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Rumiko Yamamoto
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Yusuke Butsuhara
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Tomoatsu Jimi
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Yuki Kozono
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Shuichiro Iwami
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Koichi Terakawa
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
| | - Tadayoshi Nagano
- Department of Obstetrics and Gynecology, The Tazuke Kofukai, Medical Research Institute, Kitano Hospital, 2-4-20 Kita-Ku, Osaka City, Osaka 530-8480 Japan
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10
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Zhang D, Ge H, Li J, Wu X. A new method of surgical margin assuring for abdominal radical trachelectomy in frozen section. Eur J Cancer 2015; 51:734-41. [PMID: 25702584 DOI: 10.1016/j.ejca.2015.01.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 01/19/2015] [Accepted: 01/28/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this study was to introduce a new method of assuring surgical margins for abdominal radical trachelectomy (ART) and report our experience using the method. METHODS We combined transverse and perpendicular sections to assess surgical margins of specimens from RT. All surgeries from 1st August 2012 to 1st October 2013 were performed by one surgeon. The frozen section (FS) was consistently performed by a group of gynaecologic pathologists according to the detailed protocol described in this article. All cases were prepared by the same pathologist, and the slides were reviewed by two pathologists. RESULTS There were 53 patients treated using the new method in our institution. The patient ages ranged from 20 to 41 years old (median 32). The surgeries were performed for clinical stage IA (n = 11) with LVSI and IB (n = 42) tumours (40 squamous cell carcinoma, 11 adenocarcinoma, two adenosquamous and two others). In 20 (37.74%) cases, no residual tumour of the ART specimen on frozen section was observed in the specimens as it was cleared by the preceding loop electrical excision procedure (LEEP) or conization. The margins were initially reported as negative in 45 cases and positive in nine cases. In those nine cases, a second slice of cervix was removed and negative in six cases and positive again in two cases, the other one with positive nodes. The results of frozen sections were concordant with the final paraffin-embedded sections. There were no false negative intraoperative assessments. There were no recurrences after a median follow-up of 15.4 months (range, 6-21 months). CONCLUSIONS Combining transverse and perpendicular sections to assess surgical margins of specimens from RT makes the protocol simple, reliable and produces accurate results.
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Affiliation(s)
- Dandan Zhang
- Department of Gynecologyic Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China; Department of Obstetrics & Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Huijuan Ge
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Jin Li
- Department of Gynecologyic Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China
| | - Xiaohua Wu
- Department of Gynecologyic Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, PR China.
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Pareja R, Rendón GJ, Sanz-lomana CM, Monzón O, Ramirez PT. Surgical, oncological, and obstetrical outcomes after abdominal radical trachelectomy — A systematic literature review. Gynecol Oncol 2013; 131:77-82. [DOI: 10.1016/j.ygyno.2013.06.010] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 06/03/2013] [Accepted: 06/06/2013] [Indexed: 12/14/2022]
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12
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Tsuji N, Butsuhara Y, Yoshikawa H, Terakawa K, Nagano T. Pregnancy after neoadjuvant chemotherapy followed by abdominal radical trachelectomy in stage IB2 cervical cancer: A case report. Gynecol Oncol Case Rep 2012; 4:13-5. [PMID: 24371663 DOI: 10.1016/j.gynor.2012.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 11/26/2012] [Indexed: 11/25/2022]
Abstract
► Huge cervical cancer was treated by intra-arterial chemotherapy followed by radical trachelectomy. ► The patient conceived after abdominal radical trachelectomy and had a baby by Cesarean section.
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Affiliation(s)
- Natsuki Tsuji
- Department of Obstetrics and Gynecology, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - Yusuke Butsuhara
- Department of Obstetrics and Gynecology, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - Hiroko Yoshikawa
- Department of Obstetrics and Gynecology, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - Koichi Terakawa
- Department of Obstetrics and Gynecology, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - Tadayoshi Nagano
- Department of Obstetrics and Gynecology, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
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