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Introduction/Background The purpose of the study is to present our clinical experience, pregnancy management and long term obstetrical outcome after less radical fertility sparing surgery SLNM + laparoscopic lymphadenectomy + simple trachelectomy or large recone. Methodology From 1999–2018, 91 women with squamous or adenocarcinoma with tumor less than 20 mm in the largest diameter and infiltration less than half of cervical stroma underwent laparoscopic SLNI and select extirpation of afferent parametrial channel and frozen section (FS) of SLN and laparoscopic pelvic lymphadenectomy or only SLN. Second step is simple trachelectomy without cerclage or large recone. Results Fertility was definitely spared in 76 women. 3 women (3.3%) not plan pregnancy, 9 currently plan pregnancy in future (9.9%), 64 women (84.2%) wish to be pregnant and 53 was pregnant (82.8%). From 76 fertility spared, 53 was pregnant - pregnancy rate 69.7%, 44 women have 50 baby - delivery rate was 57.9%. 37 was term pregnancy (74%), extreme premature 24–27w - 2 baby (4%), premature (28–32w) - 2 baby (4%), premature (33–37w) - 9 baby (18%). 22 unsuccessful pregnancy (5 artericial abortion, 11 spontaneus abortion in 1 trimestr, 4 spontaneus abortion in 2 trimestr, 2 GEU. Two women after hysterectomy have two baby with donor mother. Conclusion SLNM and laparoscopic pelvic lymphadenectomy with simple trachelectomy or large recone in small volume cervical cancer (less than 2cm in the largest diameter and less than half of stromal invasion) have excellent pregnancy result. This work was supported by Charles University research program PROGRES Q 28 (Oncology). Disclosure Nothing to disclose.

Objectives Purpose of study was to determine long term experience of less radical surgery, sentinel lymph node identification (SLNI) with Tc99+blue day with laparoscopic surgery. Methods From 1999 to 2018, 91 women with tumor less than 20 mm in largest diameter, infiltration less than half of cervical stroma underwent SLNI, frozen section (FS) of SLN, extirpation of afferent parametrial lymphatic channel, pelvic lymphadenectomy or only SLN. FS SLN positive patients underwent radical hysterectomy. Seven days after final histopathological processing of dissected nodes, large cone or simple trachelectomy was performed. Results 15 women (16.5%) lost fertility. 9 women had positive lymph nodes (9.9%), 2 close invasive margin (2.2%), so radical hysterectomy was performed. Four cases had SIL in margin or patient decision, had laparoscopic hysterectomy. One patient N1 had recurrence and died of disease. All other are in complete remission. Fertility was save in 76 cases. Three central recurrences (isthmic part of uterus) were observed (3.9%), one died (1.3%), 2 are in CR 15 and 7 years. We have no distant recurrence. 62 of 76 women whose reproductive ability had been maintained tried to conceive (82%). Of these 62 women, 49 became pregnant (79%) in total 76 pregnancies. 43 mothers gave birth to 48 children, two children were by surrogate mothers. Conclusions Less radical fertility sparing surgery in early cervical cancer can be feasible method that yields high, successful pregnancy rate. This work was supported by the Charles University research program PROGRES Q 28 (Oncology).