[Radical trachelectomy: From the laparoscopic approach to the vaginal route].
OBJECTIVE
To report our experience of laparoscopic and vaginal radical trachelectomies.


METHODS
Between February 2001 and May 2005, 10 patients met the requirements for a trachelectomy: 6 for a laparoscopic procedure, 4 for a vaginal procedure. In the laparoscopic procedure, coagulation of the uterine artery had to be performed in 2 patients whereas in the vaginal approach, it was always possible to conserve it.


RESULTS
Mean age was 30 years. Median follow-up time was 25 months. Five patients were grade Ia2 and five were grade Ib1. One patient presented numerous lymphatic emboli and underwent radiation and chemotherapy. She died of a peritoneal progression of the disease. One had her baby with a scheduled C-section. One had a spontaneous miscarriage at 7 weeks.


CONCLUSIONS
The radical trachelectomy technique as described by Professor Dargent relies on the selective ligature of the cervico vaginal arteries and the necessity to preserve the uterine arteries. In our experience and that of others reported in the literature, the laparoscopic approach does not always permit to conserve them. In our opinion, the vaginal approach constitutes the best option.
Bafghi
A
A
Service de Chirurgie Gynécologie, Institut Gustave-Roussy, 39, rue, Camille-Desmoulins 94800 Villejuif. abafghi@hotmail.com
Castaigne
D
D
Pomel
C
C
D000328:Adult; D002584:Cervix Uteri / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D014621:Vagina