Trachelectomy, also known as cervicectomy, is the surgical removal of the cervix, the neck of the uterus. Developed in France by Dr. Daniel Dargent in the mid-1990s as an alternative to radiation therapy and radical hysterectomy, surgery in which the entire uterus and cervix are removed, trachelectomy keeps the uterine body intact in an effort to retain fertility after healing. Generally, there are two variants: simple and radical.
Simple trachelectomy is akin to a specific type of biopsy called cervical conization. Tissue samples are removed from the mucous membrane for analysis; if pre-cancerous cells are discovered, then they can be removed by this biopsy. If the cancer has spread, radical trachelectomy may be the next resort.
Radical trachelectomy is the total removal of the cervix and adjacent tissues. Often it is accompanied by a lymphadenectomy, surgical removal of the lymph nodes via laparoscopic instruments. Its effectiveness is on par with radical hysterectomy for treating cervical cancer as long as the tumors are between two and three centimeters (.78 to 1.18 inches).
After the upper part of the vagina has been reattached to the uterus, a cerclage, or cervical stitch, is permanently placed at what would be the passageway from the cervix to the uterine cavity. This is why full-term pregnancies in women who have had this procedure culminate with a caesarian section — the baby cannot make its way down the birth canal. Regarding recovery, radical trachelectomy is typically thought to be quicker and less painful than simple trachelectomy. Women can expect to carry a pregnancy after they are completely recovered, a time span ranging from six to nine months after the operation.
After surgery, radical trachelectomy and radical hysterectomy have similar rates of recurrence, 4 percent, and death after recurrence, 2 percent. Roughly 37 percent of women who have chosen radical trachelectomy have carried full-term. There is a no chance of maintaining fertility after a radical hysterectomy.
Gynecological oncologists perform trachelectomy on young women with early cervical cancer. In some cases, the upper part of the vagina and pelvic lymph nodes are removed, too. There may be a higher propensity for miscarriage for women having undergone trachelectomy.
Often brought to light and diagnosed on Pap smears, around 471,000 women are diagnosed with cervical cancer each year worldwide. In the US alone, about 3,500 women die from invasive forms of the disease. In some cases, oophorectomy, surgical removal of one or both ovaries, may go hand-in-hand with trachelectomy.