Trachelectomy for cancer of the cervix: dargent's operation. Vaginal hysterectomy for early cancer of the cervix stage IA1 and CIN III

Radical vaginal trachelectomy is today an established method of treating selected women with cervical cancer stage IA2 and IB1, with tumour size less than 2cm without precluding future childbearing. This technique has been used for more than 20 years with reassuring oncological safety and excellent obstetrical outcomes. The procedure is a combination of laparoscopy for pelvic lymphadenectomy and challenging classic vaginal surgery to resect the tumour, part of the parametrium and upper vagina. Complications are in the range of 8-13%. Recurrence and death occur in 5 and 3%, respectively, as good as figures for radical hysterectomy. Rate of second trimester miscarriage is 8-10%, and that of preterm delivery 20-30%. More than 900 cases with 200 children are now reported in the published literature.