Affiliation:
1. National Cancer Institute
Abstract
The aim is to improve treatment efficacy and life quality of patients with malignant trophoblastic tumours.
Fertility-sparing hysterotomy with uterine reconstruction was carried in 16 patients aged of 17 to 32 years: 2 cases due to urgent and 13 – due to planned indications.
On the basis of research, the indications for the urgent and planned fertility-sparing hysterotomy with uterine reconstruction in patients with malignant trophoblastic tumours were formulated. No postoperative complications. Steady remission in all cases. Follow up from 1 to 17 years (averaged 9.2 years).
1. Localized uterine resection with uterine reconstruction – the method of choice in malignant trophoblastic tumours surgical treatment;
2. Fertility-sparing hysterotomy with uterine reconstruction is only possible in centers which are experienced in the complex multimodality treatment of gestational trophoblastic neoplasms;
3. Basic requirement of fertility-sparing surgery is beginning adjuvant chemotherapy as soon as possible.
Reference22 articles.
1. Seckl, M. J., Sebire, N. J., Fisher, R. A., Golfier, F., Massuger, L., Sessa, C. (2013). Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 24, 39–50. doi: 10.1093/annonc/mdt345
2. Tse, K. Y., Ngan, H. Y. S. (2012). Gestational trophoblastic disease. Best Practice & Research Clinical Obstetrics & Gynaecology, 26 (3), 357–370. doi: 10.1016/j.bpobgyn.2011.11.009
3. Moodley, M., Moodley, J. (2003). Transcatheter angiographic embolization for the control of massive pelvic hemorrhage due to gestational trophoblastic disease: A case series and review of the literature. International Journal of Gynecological Cancer, 13 (1), 94–97. doi: 10.1046/j.1525-1438.2003.13016.x
4. Tse, K. Y., Chan, K. K., Tam, K. F. et. al. (2007). 20-year experience of managing profuse bleeding in gestational trophoblastic disease. The Journal of reproductive medicine, 52, 397–401.
5. Keepanasseril, A., Suri, V., Prasad, G. R. et. al. (2011). Management of massive hemorrhage in patients with gestational trophoblastic neoplasia by angiographic embolization: a safer alternative. The Journal of reproductive medicine, 56, 235–240.