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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| Veröffentlicht in: | Cancers 2020-07, Vol.12 (7), p.1839 |
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| creator | Muallem, Mustafa Zelal Jöns, Thomas Seidel, Nadja Sehouli, Jalid Diab, Yasser Querleu, Denis |
| 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. |
| doi_str_mv | 10.3390/cancers12071839 |
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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.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers12071839</identifier><identifier>PMID: 32650542</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Anatomy ; Cadavers ; Cervix ; Connective tissue ; Dissection ; Hysterectomy ; Ligaments ; Lymph nodes ; Lymphatic system ; Nervous system ; Pelvis ; Studies ; Uterus ; Vagina ; Veins & arteries</subject><ispartof>Cancers, 2020-07, Vol.12 (7), p.1839</ispartof><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/3.0/ (the “License”). 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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.</description><subject>Anatomy</subject><subject>Cadavers</subject><subject>Cervix</subject><subject>Connective tissue</subject><subject>Dissection</subject><subject>Hysterectomy</subject><subject>Ligaments</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Nervous system</subject><subject>Pelvis</subject><subject>Studies</subject><subject>Uterus</subject><subject>Vagina</subject><subject>Veins & arteries</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdUk1rGzEQFaWhCWnOvRVBLz3Ejb4seXsoGNM2hpCEJD0LrVayFVbSVtIa_H_6QyvbaUiji94wb97M8AaADxh9obRBF1oFbVLGBAk8o80bcFIRmXDesLcv8DE4y_kR1UcpFly8A8eU8CmaMnIC_szhIgbtsoG3KqnOrTyMAd5VpFUPL7e5mGR0iX77FT6sTWX7IZm1CdltDJwHtUvBaPfl3pTkRn--D3TshxpAFTpYauWt6TdOw_lYYoi-omuTqsT9rsWBtSwZ3o9ptW-99ENfQXExvAdHVvXZnD39p-DXj-8Pi8vJ1c3P5WJ-NdGM4DIRulNN12DLcddpjVTLrbKY2q61YkYZ1QzzKRON1VgJzhDiwnLREjxtu2bG6Cn4dtAdxtabTptQkurlkJxXaSujcvL_THBruYobKRiacU6qwOcngRR_jyYX6V3Wpu9VMHHMkjBCUfUE40r99Ir6GMcU6np7FuHV1t1EFweWTjHnZOzzMBjJ3RHIV0dQKz6-3OGZ_89y-heMzLHO</recordid><startdate>20200708</startdate><enddate>20200708</enddate><creator>Muallem, Mustafa Zelal</creator><creator>Jöns, Thomas</creator><creator>Seidel, Nadja</creator><creator>Sehouli, Jalid</creator><creator>Diab, Yasser</creator><creator>Querleu, Denis</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3351-9429</orcidid></search><sort><creationdate>20200708</creationdate><title>A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication</title><author>Muallem, Mustafa Zelal ; Jöns, Thomas ; Seidel, Nadja ; Sehouli, Jalid ; Diab, Yasser ; Querleu, Denis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-7cda9d91f61ddcc0ab6faf13fdbf78343c4165479fc1a7640067f67b215bd9843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anatomy</topic><topic>Cadavers</topic><topic>Cervix</topic><topic>Connective tissue</topic><topic>Dissection</topic><topic>Hysterectomy</topic><topic>Ligaments</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Nervous system</topic><topic>Pelvis</topic><topic>Studies</topic><topic>Uterus</topic><topic>Vagina</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Muallem, Mustafa Zelal</creatorcontrib><creatorcontrib>Jöns, Thomas</creatorcontrib><creatorcontrib>Seidel, Nadja</creatorcontrib><creatorcontrib>Sehouli, Jalid</creatorcontrib><creatorcontrib>Diab, Yasser</creatorcontrib><creatorcontrib>Querleu, Denis</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Muallem, Mustafa Zelal</au><au>Jöns, Thomas</au><au>Seidel, Nadja</au><au>Sehouli, Jalid</au><au>Diab, Yasser</au><au>Querleu, Denis</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2020-07-08</date><risdate>2020</risdate><volume>12</volume><issue>7</issue><spage>1839</spage><pages>1839-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>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. 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| source | PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Anatomy Cadavers Cervix Connective tissue Dissection Hysterectomy Ligaments Lymph nodes Lymphatic system Nervous system Pelvis Studies Uterus Vagina Veins & arteries |
| title | A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication |
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