For cervical cancer cases with a low risk of relapse who wish to maintain their fertility, radical trachelectomyis an alternative to radical hysterectomy. Pelvic magnetic resonance imaging is recommended before surgery,with laparoscopic assisted lymphatic dissection required for assessment of lymphatic metastasis. If there is avisible lesion in the cervix, the specimen taken during trachelectomy should be sent for frozen section. Thecomplications of radical trachelectomy are chronic vaginal discharge, irregular vaginal bleeding, dysmenorrhea,ulceration, amenorrhea and cervical stenosis. The probability of cervical cancer recurrence with a lesion ofsimilar size is comparable with radical trechelectomy and radical hysterectomy. Two thirds of pregnancies aftertrachelectomy lead to live births of which approximately 40% of them are healthy. However, the probability ofsecond trimester abortion and pre-term labor is greater than in the general population. Because of the possibilityof uterine arterial injury in short cervix, vaginal delivery should be avoided and a cesarean operation in 37-38thweek is recommended. Adjuvant treatment with chemotherapy followed by radical trachelectomy is a suitableoption for larger lesions. On the other hand, conization or simple trachelectomy are more proper approachesfor very small lesions.
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