Observation on the curative effect and pregnancy outcome of early cervical cancer patients undergoing fertility function retention surgery via laparoscopy

Objective To analyze the outcome of oncology and pregnancy on patients with early-stage cervical cancer after undergoing fertility function retention surgery via laparoscopy. Methods Sixty-seven patients with early cervical cancer treated in Huangshi Central Hospital from January 2011 to January 2015 were selected as the research subject; 27 patients in the research group were given fertility-sparing operation, also known as transvaginal cervical cold knife conization(CKC) and laparoscopic pelvic lymphadenectomy (PLD) or total laparoscopic uterine cervix extensive resection(RT)), and the patients in the control group(40 cases)were given laparoscopic uterine extensive resection(RH); the perioperative condition, intraoperative condition and postoperative recurrence of two groups were compared, and the postoperative pregnancy status of the patients in the research group were analyzed. Results Among the 27 patients in the research group, 2 patients whose intraoperative pathological examination results did not meet the standards for the fertility-sparing operation were finally treated with RH, and the other 25 patients were successfully given CKC+ PLD or RT; In the research group, the intraoperative blood loss, postoperative exhaust time and hospital stay were better than those in the control group, and the differences were statistically significant (intraoperative blood loss: (85.6 + 25.5) ml, (102.5±31.2) ml, t=2.429, P=0.018; postoperative exhaust time: (1.4±0.3) d, (1.7±0.5) d, t=3.065, P=0.003; hospital stay : (10.2±2.4) d and (12.3±3.5), t=2.913, P=0.005), there was no statistically significant difference between the two groups in the operation time, incidence of urinary retention and postoperative infection (P>0.05); the differences between the two groups in the number of removed pelvic lymph nodes, length of cardinal ligament, length of uterosacral ligament, length of removed vaginal were not statistically significant(P>0.05); after 24 months of follow-up, the difference in postoperative recurrence rate of the two groups(4.0% (1/25)vs.5.0%(2/40)) was not statistically different (P>0.05); among 25 patients with fertility-sparing operation, 20 patients had pregnancy desire, and 6 patients were successfully pregnant(6/20), including 2 cases of full-term labor, 2 cases of preterm delivery and 2 cases of abortion. Conclusion Fertility-sparing surgery via laparoscope of early cervical cancer has good curative effect and reliable security, but the outcome of pregnancy is not ideal, and need to be improved. Key words: Cervical cancer; Fertility function retention; Laparoscope; Curative effect; Pregnancy outcome