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PDF(968 KB)
PDF(968 KB)
广泛性子宫切除术的关键解剖
Key anatomies of radical hysterectomy
广泛性子宫切除术(RH)是早期子宫颈癌的主要治疗手段,Querleu-Morrow分型以固定解剖结构作为标志,促进更加精准的切除范围。充分地理解子宫颈周围间隙、韧带、血管、神经及输尿管隧道等关键解剖结构,是充分切除及安全手术的基础。
Radical hysterectomy is the primary treatment for patients with early-stage cervical cancer. The Querleu-Morrow classification utilizes fixed anatomical structures as landmarks to promote a more precise resection range. A thorough understanding of the critical anatomical structures, such as the paracervical spaces,ligaments, vessels, nerves, and the ureteral tunnel, is the basis for adequate resection and safe surgery.
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Since the first publications about surgery for cervical cancer, many radical procedures that accord with different degrees of radicality have been described and done. Here, we propose a basis for a new and simple classification for cervical-cancer surgery, taking into account the curative effect of surgery and adverse effects, such as bladder dysfunction. The international anatomical nomenclature is used where it applies. For simplification, the classification is based only on lateral extent of resection. We describe four types of radical hysterectomy (A-D), adding when necessary a few subtypes that consider nerve preservation and paracervical lymphadenectomy. Lymph-node dissection is considered separately: four levels (1-4) are defined according to corresponding arterial anatomy and radicality of the procedure. The classification applies to fertility-sparing surgery, and can be adapted to open, vaginal, laparoscopic, or robotic surgery. In the future, internationally standardised description of techniques for communication, comparison, clinical research, and quality control will be a basic part of every surgical procedure.
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中国医师协会妇产科医师分会人工智能专业组. 子宫颈癌手术治疗质量控制标准中国专家共识之QM-C2型广泛性子宫切除篇[J]. 中国实用妇科与产科杂志, 2022, 38(1):66-72.
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王亚男, 蒋芳, 向阳. 早期子宫颈癌非广泛性手术治疗研究进展[J]. 中国实用妇科与产科杂志, 2023, 39(10):1039-1041.
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