Total laparoscopic radical trachelectomy in the treatment of early-stage cervical cancer: Review of technique and outcomes

摘要

Purpose of review: Fertility preservation in early-stage cervical cancer by total laparoscopic radical trachelectomy (TLRT) is gaining acceptance as more cases are published in the literature. The objective is to review all the literatures regarding TLRT especially over the last 12 months and to describe the technique, the operative outcomes, the oncologic outcomes and the obstetric outcomes of this procedure. Recent findings: As the number of cases reported in the literature increases, the effectiveness of TLRT for treating early-stage cervical cancer continues to gain support. Under the enhanced vision of the laparoscopy, it is easy to preserve the ascending branches of the uterine arteries and to divide the ligaments surrounding the cervix and vagina. Since TLRT was first reported, about 140 cases of TLRT have been reported. The tumour recurrence rate is 2.9%. Fifty-nine out of 140 patients attempted to conceive after TLRT, and forty-six patients succeeded. There were 17 miscarriages, 14 preterm births and 11 term births. Summary: TLRT appears well tolerated and effective when performed in centres with appropriate experience of laparoscopic techniques. Continued research and clinical trials are needed to further elucidate the equivalence or superiority of TLRT to conventional methods in terms of obstetric outcome and patients' quality of life.