Fertility-sparing radical vaginal or abdominal trachelectomy in select young women with stage I cervical cancer has become an acceptable alternative to radical hysterectomy in many gynecologic oncology practices worldwide.1–8 The abdominal operation also has broadened the use of radical trachelectomy beyond the laparoscopic/vaginal approaches initially described and popularized by Dargent et al.9,10 Since 2001, the authors began offering fertility-sparing radical trachelectomy procedures through the vaginal approach to select women with stage I cervical cancer who have a strong desire to preserve reproductive function. In 2004, the authors began performing radical abdominal trachelectomy in pediatric patients who were not candidates for the vaginal approach.11 This experience broadened their inclusion criteria to offer this important operation to many patients interested in fertility preservation. Currently, the authors use both approaches, vaginal or abdominal, and select candidates for either laparoscopic/vaginal approaches or the abdominal approach based on lesion characteristics and patient anatomy to provide the most adequate oncologic resection with the best hope of preserving reproductive function and fertility. This article reports the surgical and pathologic findings of fertility-sparing radical trachelectomy using a standardized surgical technique, and reports on the rate of posttrachelectomy outcomes.
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. Curtin JP Hoskins WJ Venkatraman ES Adjuvant chemotherapy versus chemotherapy plus pelvic irradiation for high-risk cervical cancer patients after radical hysterectomy and pelvic lymphadenectomy (RH-PLND): a randomized phase III trial. Gynecol Oncol 1996; 61: 3– 10.