Does radical trachelectomy influence uterine blood supply?

Area of Science:

• Gynecologic Oncology
• Reproductive Medicine
• Vascular Surgery

Background:

• Radical trachelectomy is a fertility-sparing surgical option for young women with early-stage cervical cancer.
• Preterm delivery is a significant concern for pregnancies following radical trachelectomy.
• Uterine blood supply is crucial for a healthy pregnancy, and its alteration could contribute to preterm birth.

Purpose of the Study:

• To evaluate the impact of radical trachelectomy with pelvic and parametric lymphadenectomy on uterine blood supply.
• To determine if decreased uterine perfusion is a potential cause of preterm birth in patients undergoing this procedure.

Main Methods:

• Doppler sonography was used to measure the resistance index (RI) of the uterine artery in 14 patients before and after radical trachelectomy.
• A control group of 14 healthy students underwent similar Doppler sonography measurements.
• Patients had early-stage cervical cancer (Ia1 L1 to 1b1) and underwent radical trachelectomy with pelvic and parametric lymphadenectomy.

Main Results:

• The mean RI decrease in the uterine artery post-surgery was 0.06 on the right and 0.07 on the left.
• Absolute RI values after surgery were comparable to those in the healthy control group.
• No significant difference in uterine artery resistance index was observed between pre- and post-operative measurements or compared to controls.

Conclusions:

• Radical trachelectomy combined with pelvic and parametric lymphadenectomy does not compromise uterine perfusion.
• Uterine blood supply remains adequate after this fertility-sparing procedure.
• The findings suggest that altered uterine perfusion is unlikely to be the primary cause of preterm birth in subsequent pregnancies.