[Clinical long term observations on the function of ovaries autotransplanted at radical hysterectomy on cervical carcinoma patients].
A policy to preserve the ovary is adopted in our seminar when subjects are young women and the type of the tissue is squamous cell carcinoma during total radical hysterectomy of cervical carcinoma. As one of the preservation methods, by pathohistological examination for operatively extirpated matter, postoperative radiation therapy is indicated to the cases a) that infiltration into the parametrium is observed, b) that residue of infiltrate tissue is guessed in a segment of the vagina and c) that metastasis to the pelvic lymph node is confirmed. However, during practice of postoperative irradiation, ovarian autotransplantation to outside of irradiating field has been carried out to prevent functional extinction of preserved ovary due to irradiation. As transplantation, the ovary is detached from the peripheral tissue with connecting the ovarian artery and vein to it to make movable, then is moved and transplanted with both vessels. There are two sites for transplantation, which are the submamma and the upper lateral region of abdomen. Thus subcutaneous preservation is done in a manner of envelopment with lipid. Most ovaries transplanted begin to repeat swelling and reduction according to ovulocycle. Patients record change in ovarian size concurrently with basal body temperature (BBT). In addition, we have been continuing measurement of LH, FSH, estradiol and progesterone in the blood to examine endocrine function of transplanted ovary during regular physical examination over a long period for discharged patients. In this study, out of 61 cases with transplantation, especially, 43 cases for whom long term follow-up for 6 years since 6 months after transplantation had been able to be carried out were researched about their ovarian functions. We report on it together with existence of influence of preserved ovary to therapeutic findings in cervical carcinoma. All of 43 cases show continuation of ovarian swelling cycle. In 28 cases recording both BBT and ovarian swelling, analysis for total of 407 cycles revealed normal biphasic cycle, 54.8%, luteal phase insufficient cycle, 23.1% and luteal phase defect cycle, 11.3%. Analysis of blood hormones in 26 cases showed the same secretory activity of sex hormones in each cycle of transplanted ovaries as that in normal mature ovaries, and showed maintenance of feed back to sex center.(ABSTRACT TRUNCATED AT 400 WORDS)
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000601:surgery*; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D010053:Ovary / Q000503:physiopathology / Q000637:transplantation*; D011374:Progesterone / Q000097:blood; D002583:Uterine Cervical Neoplasms / Q000503:physiopathology / Q000601:surgery*
D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone