A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication
The current understanding of radical hysterectomy is more centered on the uterus and little is discussed regarding the resection of the vaginal cuff and the paracolpium as an essential part of this procedure. The anatomic dissections of two fresh and 17 formalin-fixed female pelvis cadavers were uti...
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MDPI AG
2020-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/7/1839 |
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| author | Mustafa Zelal Muallem Thomas Jöns Nadja Seidel Jalid Sehouli Yasser Diab Denis Querleu |
| author_facet | Mustafa Zelal Muallem Thomas Jöns Nadja Seidel Jalid Sehouli Yasser Diab Denis Querleu |
| author_sort | Mustafa Zelal Muallem |
| collection | DOAJ |
| description | The current understanding of radical hysterectomy is more centered on the uterus and little is discussed regarding the resection of the vaginal cuff and the paracolpium as an essential part of this procedure. The anatomic dissections of two fresh and 17 formalin-fixed female pelvis cadavers were utilized to understand and decipher the anatomy of the pelvic autonomic nerve system (PANS) and its connections to the surrounding anatomical structures, especially the paracolpium. The study mandates the recognition of the three-dimensional (3D) anatomic template of the parametrium and paracolpium and provides herewith an enhanced scope during a nerve-sparing radical hysterectomy procedure by precise description of the paracolpium and its close anatomical relationships to the components of the PANS. This enables the medical fraternity to distinguish between direct infiltration of the paracolpium, where the nerve sparing technique is no longer possible, and the affected lymph node in the paracolpium, where nerve sparing is still an option. This study gives rise to a tailored surgical option that allows for abandoning the resection of the paracolpium by FIGO stage IB1, where less than 2 cm vaginal vault resection is demanded. |
| first_indexed | 2024-03-10T18:36:29Z |
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| id | doaj.art-51c5a38c985c4a819e54de492c14751b |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T18:36:29Z |
| publishDate | 2020-07-01 |
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| record_format | Article |
| series | Cancers |
| spelling | doaj.art-51c5a38c985c4a819e54de492c14751b2023-11-20T06:12:45ZengMDPI AGCancers2072-66942020-07-01127183910.3390/cancers12071839A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical ImplicationMustafa Zelal Muallem0Thomas Jöns1Nadja Seidel2Jalid Sehouli3Yasser Diab4Denis Querleu5Department of Gynecology with Center for Oncological Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Virchow Campus Clinic, Charité Medical University, 13353 Berlin, GermanyDepartment of Anatomy, Mitte Campus Clinic, Charité Medical University, 10117 Berlin, GermanyDepartment of Anatomy, Mitte Campus Clinic, Charité Medical University, 10117 Berlin, GermanyDepartment of Gynecology with Center for Oncological Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Virchow Campus Clinic, Charité Medical University, 13353 Berlin, GermanyDepartment of Gynecology, Portland Hospital, Portland, VIC 3305, AustraliaDepartment of Surgery, Institut Bergonié, 33076 Bordeaux, FranceThe current understanding of radical hysterectomy is more centered on the uterus and little is discussed regarding the resection of the vaginal cuff and the paracolpium as an essential part of this procedure. The anatomic dissections of two fresh and 17 formalin-fixed female pelvis cadavers were utilized to understand and decipher the anatomy of the pelvic autonomic nerve system (PANS) and its connections to the surrounding anatomical structures, especially the paracolpium. The study mandates the recognition of the three-dimensional (3D) anatomic template of the parametrium and paracolpium and provides herewith an enhanced scope during a nerve-sparing radical hysterectomy procedure by precise description of the paracolpium and its close anatomical relationships to the components of the PANS. This enables the medical fraternity to distinguish between direct infiltration of the paracolpium, where the nerve sparing technique is no longer possible, and the affected lymph node in the paracolpium, where nerve sparing is still an option. This study gives rise to a tailored surgical option that allows for abandoning the resection of the paracolpium by FIGO stage IB1, where less than 2 cm vaginal vault resection is demanded.https://www.mdpi.com/2072-6694/12/7/1839nerve-sparing radical hysterectomyparametriumparacolpiumpelvic autonomic nerve systemtailoring the radicality |
| spellingShingle | Mustafa Zelal Muallem Thomas Jöns Nadja Seidel Jalid Sehouli Yasser Diab Denis Querleu A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication Cancers nerve-sparing radical hysterectomy parametrium paracolpium pelvic autonomic nerve system tailoring the radicality |
| title | A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication |
| title_full | A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication |
| title_fullStr | A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication |
| title_full_unstemmed | A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication |
| title_short | A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication |
| title_sort | concise paradigm on radical hysterectomy the comprehensive anatomy of parametrium paracolpium and the pelvic autonomic nerve system and its surgical implication |
| topic | nerve-sparing radical hysterectomy parametrium paracolpium pelvic autonomic nerve system tailoring the radicality |
| url | https://www.mdpi.com/2072-6694/12/7/1839 |
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