Fertility-Sparing Surgery Using Knitted TiNi Mesh Implants and Sentinel Lymph Nodes: A 10-Year Experience

Autor: Alena Chernyshova, Larisa Kolomiets, Timofey Chekalkin, Vladimir Chernov, Ivan Sinilkin, Victor Gunther, Ekaterina Marchenko, Gulsharat Baigonakova, Ji Hoon Kang
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Journal of Investigative Surgery, Vol 34, Iss 10, Pp 1110-1118 (2021)
Druh dokumentu: article
ISSN: 0894-1939
1521-0553
08941939
DOI: 10.1080/08941939.2020.1745965
Popis: Objectives The aim of this cohort study is to improve the procedure of fertility-sparing surgery and to assess oncological and reproductive follow-up outcomes after radical trachelectomy (RT) for cervical cancer (T1a2-1bNxM0). Methods We have suggested the method combining sentinel lymph nodes (SLNs) and cervicoisthmic cerclage using a superelastic knitted TiNi mesh (KTNM) implant to facilitate the primary biomechanical/retention function of the uterus. Sixty-eight consented patients, who underwent fertility-sparing surgery using both transabdominal and laparoscopic route from 2009 through 2019, were recruited in the study and prospectively followed for a mean of 69 months. Results There were no intraoperative or postoperative complications. No cervical stenoses or mesh failures were noted in all cases. The 5‐year overall and recurrence‐free survival rates were 100% and 97%, respectively. Two patients indicated recurrence, it occurred in 3 and 36 months. There were 19 (28%) spontaneous pregnancies, 6 resulted in full-term delivery, whereas 2 and 11 ended in miscarriage and early abortion, respectively. Conclusions This sparing-surgery technique is turned out to be feasible and efficient as allows to achieve well oncologic and fertility outcomes, mimicking the effect of the cervix. It complements existing surgical approaches and may provide further insight into how to overcome challenges even in aggravated cases or previously failed procedures.
Databáze: Directory of Open Access Journals
Externí odkaz: