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Article

Nerve Sparing Radical Hysterectomy: Short-Term Oncologic, Surgical, and Functional Outcomes

1
Department 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, Virchow Campus Clinic, Charité Medical University, 13353 Berlin, Germany
2
Department of urology, Mitte Campus Clinic, Charité Medical University, 10117 Berlin, Germany
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(2), 483; https://doi.org/10.3390/cancers12020483
Received: 22 December 2019 / Revised: 11 February 2020 / Accepted: 15 February 2020 / Published: 19 February 2020
(This article belongs to the Special Issue Therapies in Cervical Cancer)
There is an obvious prevalence of disparity in opinions concerning the technique of nerve-sparing radical hysterectomy and its application, despite agreement on the need to spare the pelvic autonomic nerve system during such a radical operation. Understanding the precise three-dimensional anatomy of paracolpium and its close anatomical relationship to the components of the pelvic autonomic nervous system is the key in performing the nerve-sparing radical hysterectomy. A total of 42 consecutive patients with primary cervical cancers, who were operated upon in our institution between January 2017 and June 2019, were analyzed, concerning surgical, urinary functional, and short-term oncologic outcomes. Two thirds of the patients had locally advanced tumors (T > 40 mm or pT ≥ IIA2) with a median tumor size of 44.1 mm. The nerve-sparing radical hysterectomy was combined with the complete recovery of bladder function in 90% of patients directly after surgery and in 97% of patients in the first 2 weeks. The recurrence rate in a median follow-up time of 18 months was 9.5%. The nerve-sparing radical hysterectomy approach, which depends on the comprehensive understanding of the precise entire anatomy of paracolpium, was found to be feasible and applicable, even in locally advanced tumors, with good functional results and convincing short-term oncologic outcomes. View Full-Text
Keywords: nerve-sparing radical hysterectomy; inferior hypogastric plexus; pelvic splanchnic nerves; hypogastric nerves; parametrium; paracolpium nerve-sparing radical hysterectomy; inferior hypogastric plexus; pelvic splanchnic nerves; hypogastric nerves; parametrium; paracolpium
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MDPI and ACS Style

Muallem, M.Z.; Armbrust, R.; Neymeyer, J.; Miranda, A.; Muallem, J. Nerve Sparing Radical Hysterectomy: Short-Term Oncologic, Surgical, and Functional Outcomes. Cancers 2020, 12, 483. https://doi.org/10.3390/cancers12020483

AMA Style

Muallem MZ, Armbrust R, Neymeyer J, Miranda A, Muallem J. Nerve Sparing Radical Hysterectomy: Short-Term Oncologic, Surgical, and Functional Outcomes. Cancers. 2020; 12(2):483. https://doi.org/10.3390/cancers12020483

Chicago/Turabian Style

Muallem, Mustafa Z., Robert Armbrust, Jörg Neymeyer, Andrea Miranda, and Jumana Muallem. 2020. "Nerve Sparing Radical Hysterectomy: Short-Term Oncologic, Surgical, and Functional Outcomes" Cancers 12, no. 2: 483. https://doi.org/10.3390/cancers12020483

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