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Trachelektomie

Indikationen und Operationsmethoden

Trachelectomy

Indications and surgical techniques

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Die Trachelektomie wurde erstmals von Dargent beschrieben. Er verknüpfte die endoskopische Lymphadenektomie mit der Entfernung des Gebärmutterhalses und der anhängenden Parametrien. Damit werden die reproduktiven Möglichkeiten der Patientinnen bewahrt. Neben dem vaginalen Zugangsweg wurden im Laufe der Zeit ein offen abdominales, ein laparoskopisches und ein robotorgestütztes Vorgehen beschrieben. Die Indikation bezieht sich derzeit auf Karzinome, die kleiner als 2 cm sind und keinen Befall des lymphangischen Raumes aufweisen. Die onkologische Sicherheit entspricht für diese Stadien der der klassischen radikalen Hysterektomie. Obwohl mit erheblichen Schwangerschaftsproblemen gerechnet werden muss, beträgt die Rate an lebensfähigen Kindern mehr als 50%. Doch nicht jede Frau realisiert ihren potenziellen Kinderwunsch. Die Übersicht beschreibt die derzeit angewandten operativen Verfahren, die möglichen Komplikationen und die Auswirkungen auf die Fertilität.

Abstract

The trachelectomy was first described by Professor Dargent. He combined the endoscopic lymphadenectomy with the removal of the cervix uteri and the adherent parametria. Thus the patients were able to retain their reproductive possibilities. In the course of time an open abdominal, a laparoscopic and a robot supported procedure were described besides the vaginal access. At present the indication is drawn from carcinomas that are smaller than 2 cm and show no involvement of the lymphatic region. Oncologic safety, in this stage, is ensured by classic radical hysterectomy. Although severe pregnancy difficulties must be reckoned with, the rate of viable children is higher than 50%. But not every woman fulfils her potential desire for children. The overview describes the operative procedures in current use, the possible complications and their effects on fertility.

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Authors and Affiliations

  1. St. Elisabeth-Krankenhaus, Werthmannstr. 1, 50935, Köln, Deutschland

    C. Altgassen

  2. Universitätsfrauenklinik, UK-SH, Campus Lübeck, Lübeck, Deutschland

    T. Cordes, K. Diedrich & A. Kavallaris

  3. Frauenklinik, Medizinische Hochschule, Hannover, Deutschland

    H. Hertel

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  1. C. Altgassen
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  2. T. Cordes
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  3. H. Hertel
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  4. K. Diedrich
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  5. A. Kavallaris
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Correspondence to C. Altgassen.

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Altgassen, C., Cordes, T., Hertel, H. et al. Trachelektomie. Gynäkologe 42, 925–931 (2009). https://doi.org/10.1007/s00129-009-2406-y

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  • DOI: https://doi.org/10.1007/s00129-009-2406-y

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