Trachelectomy in early cervical cancer

Objectives: To review the role of trachelectomy as a method of fertility preservation instead of traditional radical hysterectomy in early cervical cancer. Materials and Methods: We conducted our original study through research in PubMed for all original studies and reviews published in the last 10 years. We reviewed the data available on trachelectomy in early stage cervical cancer whether through abdominal route or vaginal route and laparoscopic lymphadenectomy. Moreover, we reviewed the oncologic outcome, recurrence rate and its effect on subsequent pregnancies. Results: We found that recurrence and death rates seem to be comparable between radical trachelectomy (RT) and radical hysterectomy. Complications of RT include chronic vaginal discharge, abnormal uterine bleeding, dysmenorrhea, inflammation and ulcer due to cerclage, amenorrhea, and cervical stenosis. Although around 70% can get pregnant after RT, there are increased complications of pregnancy after this procedure mainly 2nd trimester miscarriages and preterm deliveries. Conclusion: RT is a useful technique associated with an excellent pregnancy rate in fertility-preserving surgery to treat early stage cervical cancer. Selection of suitable patients for conservative treatment is the best important point for getting a good result without any recurrence or complication.