Initial experience with Dargent's operation: The radical vaginal trachelectorny
ABSTRACT To report on our initial experience with radical vaginal trachelectomy for patients with early-stage cervical cancer.
Data on patients undergoing radical vaginal trachelectomy with pelvic lymphadenectomy from 11/01 to 12/06 were collected in a prospective database.
Forty-three women with early-stage cervical cancer were operated on with the intent of fertility preservation with radical vaginal trachelectomy. Median age was 31 years (range, 20-40 years). FIGO stage for the group was: IB1, 28; IA2, 7; IA1 with lymphovascular invasion, 8. Histologic type included: squamous, 24; adenocarcinoma, 16; adenosquamous, 3. Parity for the group was: nullipara, 35; one child, 7; two children, 1. Median BMI was 24 kg/m2 (range, 19-42 kg/m2). Two patients (5%) underwent completion hysterectomy due to extensive endocervical disease. The median OR time was 330 min (range, 220-480 min). Median pelvic lymph node count was 25 (range, 9-52). Median hospital stay was 3 days (range, 3-7 days). Four patients (9%) required a second intervention for a perioperative complication. Five patients (12%) underwent adjuvant chemoradiation for pathologic risk factors determined on final pathology. Eleven (79%) of 14 women who were trying to get pregnant were able to conceive. Four (36%) required assisted reproductive techniques to conceive. Four patients delivered by cesarean section after 35 weeks and four patients are currently pregnant. With a median follow-up of 21 months in patients treated with trachelectomy alone, we have had one recurrence.
Radical vaginal trachelectomy can be incorporated into gynecologic oncology practices and appears to be a reasonable option for patients with early cervical cancer who desire to maintain their fertility. It should be discussed with candidate patients during preoperative consultation.
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ABSTRACT: The vaginal radical trachelectomy has emerged as a valuable fertility-preserving treatment option for young women with early-stage disease. Cancer-related infertility is associated with feelings of depression, grief, stress, and sexual dysfunction. Data have shown that the overall oncological outcome is safe and that the obstetrical outcome is promising. In this article, we analyze the data on the vaginal radical trachelectomy published over the last 10 years in the context of what we have learned, what issues remain unclear, and what the future holds.Gynecologic Oncology 09/2008; 111(2 Suppl):S105-10. DOI:10.1016/j.ygyno.2008.07.020 · 3.69 Impact Factor
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ABSTRACT: In this paper, the influence of the amplitude limiter of combined multiuser signals in the base station of the wideband code division multiple access (W-CDMA) system is described. The transmission performance under Rayleigh fading and interference from an adjacent 6-cell environment are evaluated by computer simulation; the tool of its simulation is MATLAB software. The relationship between limiter level and capacity degradation is clarified. Furthermore, it is shown that the introduction of the limiter is effective in reducing the dynamic range of the power amplifier. The effect of forward error correction (FEC) is also described. The results show that it is effective to use FEC in compensating the degradation by the amplitude limiter.Vehicular Technology Conference, 2002. VTC Spring 2002. IEEE 55th; 02/2002
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ABSTRACT: A complete transform domain solution to transcode MPEG-2 to H.264 is proposed. Firstly, we propose an efficient transcoding architecture for intra frames by taking advantage of the fact that the intra prediction of horizontal, vertical, and DC modes can be efficiently obtained in transform domain with very low computational complexity. Then, for the transcoding of inter frames, we analyze two major kinds of drifting error resulting from the mismatch of motion compensation: interpolation error and quantization error. The former is caused by the difference between the interpolation filters adopted in these two standards, thus very unique to the transform domain transcoding from MPEG-2 to H.264. As a major contribution of this paper, the close form of interpolation error is derived from transform domain. Experimental results show that the proposed transform domain transcoding scheme achieves very promising performance in terms of low computational complexity and high transcoded video quality, most importantly its PSNR is very close to the cascaded transcoding architecture with decoding and recoding process in pixel domain.Signal Processing Systems Design and Implementation, 2005. IEEE Workshop on; 12/2005