广泛性子宫切除术的关键解剖

李源, 向阳

中国实用妇科与产科杂志 ›› 2025, Vol. 41 ›› Issue (1) : 37-39.

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中国实用妇科与产科杂志 ›› 2025, Vol. 41 ›› Issue (1) : 37-39. DOI: 10.19538/j.fk2025010110
专题笔谈

广泛性子宫切除术的关键解剖

作者信息 +

Key anatomies of radical hysterectomy

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摘要

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。

Abstract

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.

关键词

子宫颈癌 / 广泛性子宫切除术 / 解剖 / 间隙

Key words

cervical cancer / radical hysterectomy / anatomy / space

引用本文

导出引用
李源, 向阳. 广泛性子宫切除术的关键解剖[J]. 中国实用妇科与产科杂志. 2025, 41(1): 37-39 https://doi.org/10.19538/j.fk2025010110
LI Yuan, XIANG Yang. Key anatomies of radical hysterectomy[J]. Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(1): 37-39 https://doi.org/10.19538/j.fk2025010110
中图分类号: R737.3   

参考文献

[1]
Querleu D, Morrow CP. Classification of radical hysterectomy[J]. Lancet Oncol, 2008, 9(3):297-303.
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.
[2]
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.
[3]
Yabuki Y. Twenty-first century radical hysterectomy-Journey from descriptive to practical anatomy[J]. Gynecol Oncol Rep, 2020, 34:100623.
[4]
Zapardiel I, Ceccaroni M, Minig L, et al. Avascular spaces in radical hysterectomy[J]. Int J Gynecol Cancer, 2023, 33(2):285-292.
[5]
Querleu D, Bizzarri N, Fanfani F, et al. Simplified anatomical nomenclature of lateral female pelvic spaces[J]. Int J Gynecol Cancer,Published online July 5, 2022,doi:10.1136/ijgc-2022-003531.
[6]
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.

基金

国家自然科学基金(82371757)

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