RESUMEN
Objective To investigate the changes in ovarian function and the radiotheraputic influence on ovarian function on patients with cervical squamous cell carcinoma.Methods We retrospectively analyzed 53 cases of cervical cancer patients FIGO staging Ⅰ B1-Ⅱ B who had received ovarian transposition surgery at the Maternal and Child Health Hospital of Jiangxi province from January 2009 to June 2012.All the patients included in the study were FIGO staging Ⅰ B1-Ⅱ B and had undergone radiation therapy,including 38 staging Ⅰ B1-Ⅱ A2 cervical cancer patients receiving chemo-therapy after radical radiotherapy due to the presence of risk factors and other 15 patients with stage Ⅱ B to radical concurrent chemoradiotherapy ovarian transposition.Ovarian transposition methods would include laparoscopic ovarian transposition and transabdominal ovarian transposition.15 concurrent patients with stage Ⅱ B who currently receiving chemo-radiotherapy were under laparoscopic ovarian transposition.Among the 38 radical hysterectomy patients,31 were having abdominal ovarian transposition,and the remaining 7 cases were laparoscopic.All the 53 patients had undergone radiotherapy.The levels of serum female hormones FSH,LH,E2 were determined to monitor the ovarian endocrine function.Results According to FIGO staging,18 cases were stage Ⅰ B 1,15 cases Ⅰ B2,3 cases Ⅱ A1,2 cases Ⅱ A2 and 15 cases Ⅱ B.Patients' age range was from 28 to 44 years old,with an average of 37.7 years,median age as 38 years.14 patients (63.6％) were still normal ovarian function after radiotherapy by laparoscopic ovarian transposition,which was 100.0％before radiotherapy.There was a significant difference (P＜0.05) compared with before radiotherapy.After transabdominal ovarian transposition surgery and radiotherapy,normal ovarian function 22 cases (71.0％),and there was a significant difference (P＜0.05) compared with before radiotherapy.No significant difference was found with regard to the proportion of normal ovarian function after radiotherapy between the two groups of patients with laparoscopic and transabdominal ovarian transposition (P＞0.05).Conclusion For the young cervical cancer patients,even with ovarian transposition,ovarian dysfunction was still evident after radiotherapy.There was no significant difference between laparoscopic and transabdominal ovarian transposition.
RESUMEN
Objective To evaluate the feasibility and safety of vaginal enlarged amputation of cervix to treat patients with cervical cancer of stage Ⅰ a1 and cervical intraepithelial neoplasia grade Ⅲ(CIN Ⅲ)who were unfit for conization surgery.Methods From July 2002 to May 2007,patients with cervical cancer at stage Ⅰ a1,diagnosed by pathology after loop electrosurgical excision procedure(LEEP),large area CIN Ⅲ(the area of lesion≥3/4 on colposcopy),CIN Ⅲ coexisted with vaginal intraepithelial neoplasia (VAIN)in the superior segment of vagina,CIN Ⅱ-Ⅲ recurrence or with residual lesion,positive margin after conization of cervix,who wanted to preserve fertility and(or)corpus uteri were selected to receive vaginal enlarged amputation of cervix.Results Forty-eight eases including 5 with cervical cancer in stage Ⅰ a1,38 with large area CIN Ⅲ(9 with gland involvement),2 with residual lesion and 2 with positive margin after LEEP,1 recurrence after cold knife conization,received the procedure successfully.The median age was 34 years(range 27-40),median operation time was 60 minutes(range 30-100),median blood loss was 40 ml(range 5-300),and median hospital stay was 10 days(range 7-17).After follow-up 1-39 months,no patient had postoperative complications and recurrence,and all patients resumed normal menstrual cycle and sexual life.Condusion Vaginal enlarged amputation of cervix appears to be a safe and feasible procedure for patients with cervical cancer at stage Ⅰ a1 and CIN Ⅲ who are unfit for conization surgery.