Lesions should be smaller than 2 cm to achieve the most favorable outcomes. Masses up to 3 cm can be resected, but the recurrence rate is higher, especially if the tumor has invaded the lymph-vascular space.
Resect the cervix 0.5 to 1 cm distal to the isthmus. If the proximal incision margin has cleared the cancer, close the peritoneum and suture the vaginal mucosa to the cervical stump.
The rate of second-trimester loss is elevated as a result of subclinical chorioamnionitis due to exposure of the membranes to vaginal flora. The Saling procedure has been shown to prevent ascending infections.
The majority of women who have undergone radical vaginal trachelectomy successfully conceive, and most pregnancies result in a live birth.