Cervical precancerous lesions have a chance to preserve fertility Doctor: Regular screening is the key!
“Six minutes to save a life” is a slogan familiar to many women. Precancerous lesions can be detected early through smear examination. So far, the incidence and death rate of cervical cancer have dropped by more than 70%. However, the number of cervical cancer diagnoses every year The number of patients still exceeds 1,400, and it has even been ranked among the top ten cancers in Taiwan for a long time. In fact, with the advancement of medical technology, early detection can lead to early treatment. Minimally invasive surgery is also used clinically to treat cervical cancer; Children’s General Hospital Gynecology Liu Jincheng, director of the Department of Obstetrics and gynecology, pointed out that smear examination is to find pre-cancerous lesions (lesions), and 100% of them can be treated through simple surgery. The latest “Hugo Robotic Arm” surgery has small wounds and remarkable curative effects.
Stage number and tumor size are key to minimally invasive surgery
“The key to using minimally invasive surgery is the ‘stage’.” Cervical cancer is a locally invasive tumor. Therefore, surgery is one of the important options in clinical treatment. Doctors will consider the stage, condition, age and other factors of the patient. To decide the surgical method to perform, or even to evaluate whether it is necessary to remove the uterus; Director Liu Jincheng said that if the patient is a first-stage B1 cervical cancer and the tumor is less than 2 cm, minimally invasive radical uterine surgery can be performed. Among them, Compared with traditional hysterectomy, minimally invasive surgery involves smaller wounds and faster recovery.
Director Liu Jincheng mentioned that in addition to obtaining a consensus between doctors and patients regarding the method and choice of surgery, it is also necessary to confirm through MRI and other examinations before performing the surgery that there is no invasion of the parauterine tissue and that the disease has not metastasized. The most important thing is the doctor’s experience and familiarity It greatly affects the success rate. Cervical cancer patients belonging to Stage I A can be treated by simple hysterectomy or cervical conization (Conization). If it is a more severe stage, a radical total cervical excision is required, including the removal of tissue around the cervix, lymph glands and even part of the vagina. This is different from traditional hysterectomy.
Judging from the current minimally invasive surgery, in addition to the well-known Da Vinci robotic arm surgery, the “Hugo robotic arm” surgery provides new treatment options for cervical cancer patients. Director Liu Jincheng mentioned that it is the biggest difference from previous surgeries. The difference is that Hugo robotic arm surgery can provide an open operating space, allowing the doctor to be in a more suitable posture when performing the surgery, and does not require long-term compression of the cervical spine, helping to completely remove the lesion and improve the quality of the surgery.
Hugo robotic arm-assisted surgery has good results in treating cervical cancer
Director Liu Jincheng explained that the tumor is usually covered with vaginal epithelium before surgery, and the uterus is finally taken out of the vagina to prevent the tumor from traveling to the abdominal cavity during the process. The Hugo robotic arm has independent limbs and can be used during the operation. Different angles are adjusted according to the site where the surgery is required. Since this surgery was introduced to Taiwan last year (2023), there have been many successful cases of it being used in the treatment of cervical cancer, and the patients recovered quickly after surgery and had few complications. However, regular follow-up visits are still recommended.
Many cervical cancer patients are most concerned about the impact on “fertility.” Director Liu Jincheng emphasized that as long as it is cancer in situ, fertility can be preserved almost 100% of the time. Even if it is an invasive cancer below stage B, as long as there is no metastasis, Lymph gland or blood vessel lymphoid tumor embolism can be used to retain the uterus through cervical eradication surgery. However, it is worth noting that for patients who have had their uterus removed, there is still a risk of gynecological diseases. Subsequent regular inspections and follow-up are necessary.
Are there any worries about the sequelae of cervical cancer? Doctor: Don’t worry about affecting your daily life
In addition, patients with cervical cancer who undergo surgical treatment are most worried about possible sequelae. In fact, as long as relevant health education and home care are provided, they can gradually return to daily life; Director Liu Jincheng emphasized that whether it is benign or malignant, For cancer patients, postoperative urination, defecation functions and even sexual life will not be greatly affected by surgical factors.
Director Liu Jincheng reminded that the most important thing in the prevention and treatment of cervical cancer is to undergo regular smear tests. Even now there is so-called “self-sampling”, where vaginal specimens are collected at home for human papillomavirus (HPV) screening and then triage. Go to the outpatient clinic to receive a smear test. In addition, receiving the cervical cancer vaccine can reduce the chance of being infected with HPV by 90%. As long as it is discovered early and receives timely treatment, the cure rate can also be improved.
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