title: Abdominal radical trachelectomy: a safe and feasible option for fertility preservation in developing countries.
abstract: OBJECTIVE
  This study aimed to report on a series of patients with early-stage cervical cancer who underwent an abdominal radical trachelectomy to preserve their fertility.
  
  
  METHODS
  We performed a retrospective review of all patients who underwent an abdominal radical trachelectomy in 2 centers of gynecologic oncology in Argentina. Data collected included patient's age, stage, histologic subtype, tumor grade, tumor size, evidence of lymph vascular space invasion, number of lymph nodes removed, perioperative complications, as well as oncologic and obstetrical outcomes.
  
  
  RESULTS
  Thirty patients were selected for radical trachelectomy. Five of these patients were excluded from the study: 3 for compromised margins, 1 for lymph node involvement, and 1 for vesicovaginal space involvement. Twenty-five patients underwent the procedure and were included in this report. Median age was 31 years (range = 22-40 years). Nineteen patients had stage IB1, and 6 patients had stage IA2 cervical cancer. Median tumor size was 1.2 cm (range = 0.4-3.5 cm). Median number of pelvic lymph nodes removed was 21 (range = 11-33). Median surgical time was 240 minutes (range = 210-270 minutes), and median length of hospital stay was 3.5 days (range = 3-5 days). Estimated blood loss was 350 mL (range = 200-700 mL). No intraoperative complications were reported. There were 6 postoperative complications. Three patients (12%) were able to get pregnant spontaneously with 3 live births by cesarean delivery. No recurrences were reported with a median follow-up of 29.6 months.
  
  
  CONCLUSIONS
  Abdominal radical trachelectomy with pelvic lymphadenectomy is a feasible procedure and a viable option for women wishing to preserve their fertility in developing countries.
authors.affiliation: 1Department of Gynecologic Oncology, Gynecology Service, Hospital Italiano de Buenos Aires, Escuela de Medicina Instituto Universitario, Buenos Aires, Argentina; 2Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; and 3Department of Gynecologic Oncology, Gynecology Service, Hospital Nacional Universitario de Clínicas, Córdoba, Argentina.
authors.forename: Roberto
authors.initials: R
authors.lastname: Testa
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
authors.forename: Héctor
authors.initials: H
authors.lastname: Ferreyra
authors.forename: José
authors.initials: J
authors.lastname: Saadi
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Franco
authors.forename: Marcos
authors.initials: M
authors.lastname: Goldsman
authors.forename: Myriam
authors.initials: M
authors.lastname: Perrotta
mesh_terms: D000328:Adult; D001118:Argentina; D002584:Cervix Uteri / Q000601:surgery*; D003906:Developing Countries; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D010388:Pelvis; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D055815:Young Adult