Abstract
Summary. The increase in the number of women of childbearing age with miscarriage due to isthmic-cervical insufficiency after organ-preserving methods of treatment of precancer and initial cervical cancer increases the urgency of developing an effective method of surgical correction at the pre-gravid stage of this group of patients.
Aim. Determination of indications for surgery and study of reproductive results after performing laparoscopic cerclage in women who underwent organ-preserving treatment for precancer and initial stages of cervical cancer in the anamnesis.
Materials and methods. The main group included 40 women after laparoscopic cerclage who, 2 to 5 years ago, underwent organ-preserving treatment for grade II-III cervical intraepithelial neoplasia and Tis and T1a1N0M0 cervical cancer. The comparison group consisted of 40 women who, 2 to 5 years ago, underwent organ-preserving treatment for cervical intraepithelial neoplasia of the II-III degree and cervical cancer Tis and T1a1N0M0. Laparoscopic cerclage in the main group was performed on patients during pre-gravid preparation.
Results and their discussion. Performing a laparoscopic cerclage of the uterus in women planning pregnancy after organ-preserving surgical intervention for precancer and initial stages of cervical cancer is a necessary stage of pregravid preparation, which reduces the number of reproductive losses. The possibility of highly effective treatment using minimally invasive methods and a low risk of postoperative complications allows considering laparoscopic cerclage as the best method of surgical correction at the pre-gravid stage of this group of patients, which helps prolong pregnancy to full term.
Conclusions. Laparoscopic cerclage becomes a better method of treatment and allows to prevent perinatal losses in patients with an operated cervix and a history of miscarriage.
Publisher
Institute of General and Emergency Surgery Named after V.T. Zaitsev NAMS of Ukraine