医学
外科
气管切除术
回顾性队列研究
纤维接头
剖腹手术
袖口
子宫颈
狭窄
宫颈癌
癌症
放射科
内科学
作者
Miaochun Xu,Chuying Huo,Chunxian Huang,Bin Wu,Yunyun Liu,Jing Li,Xiaoting Ling,Guocai Xu,Zhongqiu Lin,Huaiwu Lu
标识
DOI:10.1016/j.jmig.2022.01.002
摘要
ABSTRACT
Study Objectives
The purpose of this study was to evaluate the feasibility of "cuff-sleeve" sutures for reconstructing a functional neocervix in laparoscopic radical trachelectomy (RT). Design
A retrospective analysis of a case series. Setting
A teaching hospital. Patients
Twenty-five patients who were diagnosed as early-stage cervical cancer from June 2017 to October 2020 in Sun Yat-sen Memorial Hospital. Interventions
Laparoscopic RT with the "cuff-sleeve" suture method for cervicovaginal reconstruction. Measurements and Main Results
Twenty-five patients successfully underwent the laparoscopic RT with the "cuff-sleeve" suture method for cervicovaginal reconstruction, and no intraoperative complications occurred or conversion to laparotomy was needed. For all patients, approximately 80% of the cervical length was removed. Surgical radicality and negative surgical margins were also confirmed. During a median follow-up time of 29 months (range 8–48 months), no severe postoperative complications were observed. No cervical stenosis or secondary abnormal menstruation was reported. After the removal of the uterine stent 6 months after surgery, the neocervix length was approximately 14 mm (range 10–19 mm) and almost all the neocervixes were restored closely to the original anatomy. Four of 8 patients attempting actively to conceive were successful, and the cervical length of these pregnant patients was greater than or equal to 15 mm in all but one measurement at different gestational age. Three patients were ongoing pregnant, and the other had delivered successfully with a 16- mm cervix at term without cerclage. Conclusion
The "cuff-sleeve" suture method in cervicovaginal reconstruction is feasible in laparoscopic RT. This simplified suture technique can provide a functional neocervix to reduce cervical stenosis and incompetence.
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