دورية أكاديمية

Uterine transposition for fertility and ovarian function preservation after radiotherapy

التفاصيل البيبلوغرافية
العنوان: Uterine transposition for fertility and ovarian function preservation after radiotherapy
المؤلفون: Ribeiro, Reitan, Baiocchi, Glauco, Moretti-Marques, Renato, Linhares, José Clemente, Costa, Caroline Nadai, Pareja, Rene
المساهمون: Erasto Gaertner Hospital
المصدر: International Journal of Gynecologic Cancer ; volume 33, issue 12, page 1837-1842 ; ISSN 1048-891X 1525-1438
بيانات النشر: BMJ
سنة النشر: 2023
الوصف: Objective To evaluate the feasibility of uterine transposition as a method of preserving fertility and ovarian function after pelvic radiation. Methods This prospective multicenter observational study included patients with non-gynecologic pelvic cancers who underwent pelvic radiation as part of their cancer treatment between June 2017 and June 2019. For inclusion in the study, patients were required to have normal menstrual cycles and hormone levels (follicle-stimulating hormone, luteinizing hormone, and estrogen) before treatment. Uterine transposition to the upper abdomen was performed prior to irradiation. Clinical examinations and Doppler ultrasonography were used to evaluate the gonadal vasculature post-surgery. The uterus was repositioned into the pelvis 2–4 weeks after radiation therapy or at the time of rectosigmoid resection in patients with rectal cancer who had undergone neoadjuvant treatment. Cancer treatment and follow-up were performed according to standard guidelines. Results Eight patients (seven with rectal cancer and one with pelvic liposarcoma) underwent uterine transposition at a median age of 30.5 years (range 19–37). The uterus was successfully preserved in six patients, accompanied by normal menses, hormonal levels, and vaginal intercourse after treatment. One patient with rectal cancer died of carcinomatosis 4 months after uterine transposition. One patient presented with uterine necrosis 4 days after uterine transposition, and the uterus was removed; however, one ovary was preserved. Cervical ischemia was the most common post-surgical complication in three (37.5%) patients. Three patients attempted to conceive, and two (66%) were spontaneously successful and delivered healthy babies at 36 and 38 weeks by cesarean section without complications. Conclusions Uterine transposition is a feasible procedure for preserving gonadal and uterine function in patients requiring pelvic radiotherapy for non-gynecological cancer, with the potential for achieving spontaneous pregnancy and successful ...
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1136/ijgc-2023-004723
الإتاحة: https://doi.org/10.1136/ijgc-2023-004723Test
رقم الانضمام: edsbas.8F44B69D
قاعدة البيانات: BASE