国际妇产科学杂志 ›› 2024, Vol. 51 ›› Issue (6): 669-671.doi: 10.12280/gjfckx.20240787

• 妇科肿瘤研究:病例报告 • 上一篇    下一篇

宫颈癌ⅠB2期新辅助化疗根治性宫颈切除术后再妊娠一例

刘昱, 吴瑞芳, 李瑞珍()   

  1. 518036 北京大学深圳医院妇产科
  • 收稿日期:2024-08-30 出版日期:2024-12-15 发布日期:2024-12-16
  • 通讯作者: 李瑞珍,E-mail:lrz6666@126.com
  • 基金资助:
    深圳市生殖保存与生育力保护公共服务平台(XMHT20220104049)

A Case Report of Pregnancy after Radical Cervicectomy with Neoadjuvant Chemotherapy in Stage ⅠB2 Cervical Cancer

LIU Yu, WU Rui-fang, LI Rui-zhen()   

  1. Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
  • Received:2024-08-30 Published:2024-12-15 Online:2024-12-16
  • Contact: LI Rui-zhen, E-mail: lrz6666@126.com

摘要:

随着宫颈病变筛查的普及和阴道镜的熟练应用,越来越多的早期宫颈癌患者得以发现,其发病趋势呈现年轻化。宫颈癌治疗的同时保留生育功能有很大的临床需求。对于宫颈肿瘤直径较大又希望保留生育功能的宫颈癌患者,先行新辅助化疗“降级”肿瘤分期再行根治性宫颈手术,使妊娠成为可能。报道1例26岁ⅠB2期宫颈癌患者先行新辅助化疗缩小肿瘤后再行根治性宫颈切除术,术中保留双侧子宫动脉上行支并于子宫峡部放置补片预防宫颈机能不全,术后11个月补片暴露予以拆除。患者术后2年余成功妊娠。通过此病例探讨术中放置补片的必要性及剖宫产术式的选择。

关键词: 宫颈肿瘤, 子宫颈切除术, 辅助放化疗, 妊娠, 病例报告

Abstract:

With the popularity of cervical cancer screening and the proficient use of colposcopy, an increasing number of patients with early-stage cervical cancer are being diagnosed, and the trend of its incidence is skewing younger age. There is a significant clinical demand for preserve fertility while treating cervical cancer. For patients with large cervical tumors who wish to preserve their reproductive function, neoadjuvant chemotherapy can first ′reduce′ tumor stages, followed by radical cervical surgery to make pregnancy possible. It was reported that a 26-year-old patient with stage ⅠB2 cervical cancer underwent radical cervicectomy after neoadjuvant chemotherapy to reduce the tumor. During the operation, the bilateral ascending branches of the uterine arteries were preserved, and a patch was placed around the isthmus to prevent cervical insufficiency. The patch was exposed and removed after 11 months of exposure after the operation. The patient had a successful pregnancy nearly two years after surgery. Based on this case, the necessity of intraoperative patch placement and the choice of cesarean section were discussed.

Key words: Uterine cervical neoplasms, Trachelectomy, Chemoradiotherapy, adjuvant, Pregnancy, Case reports