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Volume 12
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10.3390/diagnostics12020519
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Article

Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space

by
Stoyan Kostov
1,
Ilker Selçuk
2,
Rafał Watrowski
3,
Yavor Kornovski
1,
Hakan Yalçın
2,
Stanislav Slavchev
1,
Yonka Ivanova
1,
Deyan Dzhenkov
4 and
Angel Yordanov
5,*
1
Department of Gynecology, University Hospital “Saint Anna”, Medical University—“Prof. Dr. Paraskev Stoyanov”, 9002 Varna, Bulgaria
2
Department of Gynecologic Oncology, Ankara City Hospital, Woman’s Health Training and Research Hospital, University of Health Sciences, Ankara 06800, Turkey
3
Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
4
Department of General and Clinical Pathology, Forensic Medicine and Deontology, Division of General and Clinical Pathology, Faculty of Medicine, Medical University—“Prof. Dr. Paraskev Stoyanov”, 9002 Varna, Bulgaria
5
Department of Gynecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria
*
Author to whom correspondence should be addressed.
Diagnostics 2022, 12(2), 519; https://doi.org/10.3390/diagnostics12020519
Submission received: 29 December 2021 / Revised: 13 February 2022 / Accepted: 15 February 2022 / Published: 17 February 2022
(This article belongs to the Special Issue Advances in Anatomy)
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Abstract

The surgical treatment of gynecological malignancies is, except for tumors diagnosed at the earliest stages and patients’ desire for fertility preservation, not limited to only the affected organ. In cases of metastatic iliac lymph nodes, gynecological tumors or recurrences located near the pelvic sidewall, oncogynecologists should dissect tissues in that region. Moreover, surgery of deep infiltrating endometriosis, e.g., within the sacral plexus, or oncological procedures, such as a laterally extended endoplevic resection or a laterally extended parametrectomy, often require a dissection of the pelvic sidewall. Dissection should be meticulous, and detailed knowledge of anatomy is mandatory. There are many controversies among authors regarding the terminology in the pelvic sidewall. In particular, several imprecise or confusing definitions exist in regard to the region located medially to the psoas major muscle. Therefore, after discussing the anatomy of the pelvic sidewall and the commonly used terminology, we define a new term and boundaries of a potential avascular space, the medial psoas space. Contrary to the variety of earlier definitions, the proposed boundaries relate to a truly avascular space and could help surgeons to avoid complications resulting from misleading anatomical descriptions. Additionally, describing the clear boundaries of and possible anatomical variations in the medial psoas space may urge oncogynecologists to consider different approaches during surgery. The purpose of the present study is to describe the anatomy of the pelvic sidewall and the applications of the medial psoas space in gynecologic oncology.
Keywords: pelvic sidewall anatomy; new term; new boundaries; potential avascular space; gynecologic oncology pelvic sidewall anatomy; new term; new boundaries; potential avascular space; gynecologic oncology

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MDPI and ACS Style

Kostov, S.; Selçuk, I.; Watrowski, R.; Kornovski, Y.; Yalçın, H.; Slavchev, S.; Ivanova, Y.; Dzhenkov, D.; Yordanov, A. Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space. Diagnostics 2022, 12, 519. https://doi.org/10.3390/diagnostics12020519

AMA Style

Kostov S, Selçuk I, Watrowski R, Kornovski Y, Yalçın H, Slavchev S, Ivanova Y, Dzhenkov D, Yordanov A. Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space. Diagnostics. 2022; 12(2):519. https://doi.org/10.3390/diagnostics12020519

Chicago/Turabian Style

Kostov, Stoyan, Ilker Selçuk, Rafał Watrowski, Yavor Kornovski, Hakan Yalçın, Stanislav Slavchev, Yonka Ivanova, Deyan Dzhenkov, and Angel Yordanov. 2022. "Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space" Diagnostics 12, no. 2: 519. https://doi.org/10.3390/diagnostics12020519

APA Style

Kostov, S., Selçuk, I., Watrowski, R., Kornovski, Y., Yalçın, H., Slavchev, S., Ivanova, Y., Dzhenkov, D., & Yordanov, A. (2022). Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space. Diagnostics, 12(2), 519. https://doi.org/10.3390/diagnostics12020519

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