Radical Trachelectomy Using A Titanium-Nickelide Metal Tricotage Implant to Preserve Fertility in Cervical Cancer Patients.

OBJECTIVE

Among malignant neoplasms of the female reproductive system, cervical cancer traditionally occupies a leading position in terms of both morbidity and mortality. Traditional surgical treatment of early-stage cervical cancer leads to satisfactory oncological results, but irreversibly reduces the fertility in this category of patients. The aim of this work was to evaluate the applicability of a metal-ceramic implant with shape memory made of titanium nickelide for the purpose of forming uterine closure and strengthening the anastomosis zone.

METHODS

A total of 168 untreated patients with cervical cancer underwent radical trachelectomy with reinforcement of the utero-vaginal anastomosis using a titanium-nickelide shape memory implant. The fertility of women after organ-preserving treatment was evaluated. Thirty-nine pregnancies were registered.

RESULTS

Currently, 28 healthy children have been born. Two patients gave birth twice, one woman gave birth to twins. In addition, 2 miscarriages were registered at 7 and 19 weeks, 7 patients terminated pregnancy for social reasons at early stages, 2 patients are currently pregnant, at 24 and 32 weeks. The median follow-up for this category of patients is 89±9.6 months. Eight relapses were registered at various follow-up periods with the localization of the relapse mainly in the area of the anastomosis and iliac vessels. Analysis of menstrual function showed that the duration of the menstrual cycle after surgical treatment in the volume of radical trachelectomy was 29±4.7 days and did not differ significantly from the indicators before the operation. The duration of menstruation also did not differ significantly before and after surgical treatment.

CONCLUSION

Improvement of the method of organ-preserving surgical treatment by radical trachelectomy with the formation of the uterine locking apparatus using titanium-nickelide metal tricotage contributes to the improvement of reproductive results without compromising oncological effectiveness.