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E u r o p e a n C o n g r e s s o n
Vaccines & Vaccination
and Gynecologic Oncology
O c t o b e r 2 6 - 2 7 , 2 0 1 8
B u d a p e s t , H u n g a r y
Vaccines & Vaccination and Gynecologic Oncology 2018
Page 34
Critical Care Obstetrics and Gynecology
ISSN: 2471-9803
Biography
Aleksandar Stefanović has finished Medical School University
of Belgrade (1977), MD (1995), PhD (1996) and academic
special studies of Gynecology and Obstetrics (1994) He has 25
years of clinical experiences, working at Clinic for Gynecology
and Obstetrics Clinical Centre of Serbia, which is the biggest
one in whole region, as Gynecologist for 18 years. He currently
serves as Director (chairman) of Clinic for Obstetrics and
Gynecology, Clinical Center of Serbia. He was President of
Association of gynecologists and obstetricians of Serbia,
Montenegro and Republic Srpska, official FIGO Member; Dean
of Medical Faculty, University of Belgrade, Serbia; President
of Expert Committee for Cervical Carcinoma Prevention and
Control; also Member of Advisory Board for the implementation
of Screening and Early Detection of Breast, Cervical and
Colorectal Carcinoma Programme, Author of National Good
Practice Guidelines for Diagnosis and Treatment of Cervical
Carcinoma, Member of Multidisciplinary Team forGynecologic
Oncology, Clinic for Obstetrics and Gynecology, Clinical Center
of Serbia. His representative publications are about 50 in CC/
SCI expanded and JCR indexed, and active participant on
more than 50 international congresses with total number of
publication about 150.
Fertility sparing surgery in early stages of
cervical cancer: the new standard of care
Aleksandar Stefanović
Clinic for Obstetrics and Gynecology-Clinical Center of Serbia, Serbia
Aleksandar Stefanović, Crit Care Obst & Gyne 2018, Volume: 4
DOI:10.21767/2471-9803-C1-001
The concept of fertility preserving surgery inearly cervical, radical trachelectomy
with stage IA2 or IB disease. Trachelectomy is a conservative oncologic
operation with the aim to preserve fertility in early stages of cervical cancer female
patients that have realized reproduction. Excised structures in trachelectomy are:
cervix, upper 1/3 of vagina, parametria and paracolpia, with preservation of uterine
corpus. After removing the vaginal fornix and cervix, uterovaginal anastomosis
with non resorptive suture is performed. Indications for trachelectomy are patients
up to 45 years of age who wish to conserve fertility with negative lymph nodes,
no distant metastatic disease, FIGO stage cervical cancer staged IA1, IA2, IB1
(tumour size ≤2cm with negative lymph nodes), with adequate cervical length,
no evidence of expansion of malignant process on the upper part of the cervical
canal, squamocellular carcinoma, rarely cervical adenocarcinoma, negative lymph
nodes intraoperatively, no metastatic disease, clear resected margins. There is an
ongoing debate regarding the need for uterine vessels preservation. Some authors
have proved that the preservation of the uterine artery is associated with more
favorable restoration of the reproductive function. Others claim that preservation
of the uterine vasculature is not necessary for fertility as obstetrical outcomes
are similar to those of the historical vaginal radical trachelectomy cohorts.
Simple trachelectomy as alternative to radical trachelectomy in selected cases
(parametrial involvement rate <1% in patients with IB1 ≤2cm, negative lymph
nodes and stromal invasion ≤ 10mm).