Organ-preserving surgery for cervical cancer
Organ-preserving surgery for cervical cancer means preserving the patient's uterus and ovarian tissue so that she can conceive and give birth to a child in the future. According to statistics, with proper diagnosis and a doctor's decision, organ-preserving operations give equally good treatment rates, as well as the removal of all reproductive organs.
Organ-preserving surgery for stage 0 cervical cancer
Early cervical cancer is traditionally treated with radical hysterectomy (removal of the uterus) or chemoradiotherapy, which can lead to infertility. In modern clinics, patients with cancer up to stage B1 (if the tumor is less than 2 cm) can expect fertility-preserving treatment.
An organ-preserving operation for uterine fibroids, neoplasia, or in situ tumors is often a loop electrosurgical procedure (LEEP). The technology is based on the removal of abnormal tissue with a loop of thin wire, which is heated using an electric current. LEEP does not require external incisions, is performed on an outpatient basis for 10 minutes and promotes rapid recovery.
Organ-preserving surgery for stage 1A cervical cancer
Stage 1A cervical cancer (a microinvasive tumor less than 3 mm deep) is well treated with conization. The procedure is performed using a colposcope (a magnifying instrument with a light source). This allows the doctor to view the internal space of the cervix and guide the instruments. The tumor is removed using a heated wire loop, a scalpel, or a light laser. Along with the neoplasm, a small section of healthy tissue is cut out in the shape of a cone to eliminate the risk of cancer returning.
Organ-preserving surgery for cervical cancer at stages 2A and 1B
Radical trachelectomy is an organ-preserving operation for cervical cancer at stages 1A with the penetration of the tumor into the lymph vessels, 2A or 1B. During this procedure, the surgeon removes the cervix, preserving the uterus and ovaries to ensure a future pregnancy.
Radical trachelectomy is prescribed if the cancer has not affected the vagina, the uterine body and surrounding tissues. The size and prevalence of the tumor is preliminarily assessed using MRI. The optimal condition for surgery is a tumor of less than 2 cm without deep penetration into the cervical tissue and without metastases in the lymph node.
The operation is usually performed through the vagina and several tiny incisions in the lower abdomen to insert a laparoscope. But in some cases, open surgery is used to identify and remove the "sentinel" lymph node. The pathologist checks the removed lymph node for the presence of cancer cells. If no metastases are found, only partial removal of the cervix is necessary, while the uterus itself remains unaffected. This preserves a woman's ability to conceive a child in the future (but only by caesarean section). The most common complications after the procedure are irregular bleeding, cycle disorders (dysmenorrhea, amenorrhea) and rarely deep dyspareunia (pelvic pain).
