Does radical trachelectomy influence uterine blood supply?
OBJECTIVE
Radical trachelectomy in combination with pelvic and parametric lymphadenectomy is indicated in young patients with early cervical cancer and planned pregnancy. If pregnancy occurs, premature delivery is a known problem in these patients. We evaluated if uterine blood supply is decreased after radical trachelectomy as one of various possible causes of preterm birth.


METHODS
Between October 2003 and April 2004, 14 consecutive patients with early cervical cancer underwent radical trachelectomy with pelvic and parametric lymphadenectomy. The uterine blood supply was measured as resistance index (RI) by Doppler sonography pre- and postoperatively. Doppler sonography of the uterine artery was also performed in 14 healthy students as a control cohort.


RESULTS
Fourteen patients with histologically confirmed adenocarcinoma or squamous carcinoma of the cervix uteri stage Ia1 L1 to 1b1 underwent radical trachelectomy. Mean age of patients was 33.4 years (31-37). On average, 11.5 mm (5-23) of cervical length and 24.6 (14-35) tumor-free lymph nodes were removed. Decrease of RI of the uterine artery was 0.06 on the right side (0.76-0.70) and 0.07 (0.75-0.68) on the left side. The absolute RI values after radical trachelectomy were not different compared to the values in the control group (0.76 versus 0.70 right side, 0.74 versus 0.68 left side).


CONCLUSIONS
Uterine perfusion after radical trachelectomy with pelvic and parametric lymphadenectomy remains unchanged.
Klemm
Petra
P
Department of Gynecology, Friedrich Schiller University, Bachstrasse 18, 07740 Jena, Germany.
Tozzi
Roberto
R
Köhler
Christhardt
C
Hertel
Hermann
H
Schneider
Achim
A
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014599:Uterus / Q000098:blood supply*