Trachelectomy

Trachelectomy

A trachelectomy, also known as a cervicectomy, is a surgical procedure that involves the removal of the cervix while preserving the uterus. This procedure is primarily performed to treat early-stage cervical cancer in women who wish to maintain their fertility.

Diagram showing the parts removed with trachelectomy surgery.

Indications

Trachelectomy is indicated for women with early-stage cervical cancer, typically stage IA2 to IB1, who desire to preserve their fertility. It is an option for women who have small tumors (usually less than 2 cm in diameter) and no evidence of lymph node involvement or distant metastasis.

Procedure

The procedure can be performed via different surgical approaches, including vaginal, abdominal, or laparoscopic methods. During a trachelectomy, the cervix, surrounding tissue, and the upper part of the vagina are removed. The pelvic lymph nodes may also be removed to check for cancer spread. The uterus is then reattached to the remaining part of the vagina, allowing for the possibility of future pregnancy.

Fertility and Pregnancy

One of the main advantages of trachelectomy over a hysterectomy is the preservation of fertility. Women who undergo this procedure can still conceive, although they are at higher risk for preterm birth and other complications. It is recommended that pregnancies following a trachelectomy be closely monitored by a specialist.

Risks and Complications

As with any surgical procedure, trachelectomy carries risks such as bleeding, infection, and damage to surrounding organs. There is also a risk of cervical stenosis, which can affect fertility and menstruation. Long-term follow-up is necessary to monitor for cancer recurrence.

Prognosis

The prognosis for women undergoing trachelectomy is generally favorable, with survival rates comparable to those who undergo more radical surgery, provided the cancer is detected early and there is no lymph node involvement.

Related pages

• Cervical cancer
• Hysterectomy
• Fertility preservation

References

• 
  Diagram showing the parts removed with trachelectomy surgery