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Fertil Steril. 1998 Nov;70(5):956-60.

Laparoscopic ovarian transposition for pelvic malignancies: indications and functional outcomes.

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  • 1Institut Gustave Roussy, Villejuif, France.

Abstract

OBJECTIVE:

To assess the indications and effectiveness of laparoscopic ovarian transposition before pelvic irradiation for a gynecologic cancer.

DESIGN:

Prospective study.

SETTING:

A gynecologic oncology department in a French anti-cancer center.

PATIENT(S):

Twenty-four patients treated for pelvic cancer.

INTERVENTION(S):

Laparoscopic ovarian transposition to paracolic gutters. Uterine conservation in 18 patients.

MAIN OUTCOME MEASURE(S):

Clinical and laboratory follow-up tests of ovarian function.

RESULT(S):

Bilateral laparoscopic ovarian transposition was achieved in 22 patients (94%). Twelve patients were treated for clear cell adenocarcinoma of the cervix and/or upper vagina, 6 patients for invasive squamous cervical carcinoma, 3 patients for pelvic sarcoma, 1 patient for recurrent cervical cancer to the upper vagina, 1 patient for ependymoma of the cauda equina, and 1 patient for ovarian dysgerminoma. Ovarian preservation was achieved in 79%. Three pregnancies were obtained.

CONCLUSION(S):

Laparoscopic ovarian transposition is a safe and effective procedure for preserving ovarian function. Bilateral ovarian transposition should be performed. The main indications for laparoscopic ovarian transposition are a patient with a small invasive cervical carcinoma (<2 cm) in a patient <40 years of age who is treated by initial laparoscopically assisted vaginal radical hysterectomy and a patient with a clear cell adenocarcinoma of the cervix and upper vagina.

PMID:
9806584
[PubMed - indexed for MEDLINE]
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