Key anatomies of radical hysterectomy

LI Yuan, XIANG Yang

Chinese Journal of Practical Gynecology and Obstetrics ›› 2025, Vol. 41 ›› Issue (1) : 37-39.

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Chinese Journal of Practical Gynecology and Obstetrics ›› 2025, Vol. 41 ›› Issue (1) : 37-39. DOI: 10.19538/j.fk2025010110

Key anatomies of radical hysterectomy

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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.

Key words

cervical cancer / radical hysterectomy / anatomy / space

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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

References

[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.
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