ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gynecological Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1555483
This article is part of the Research TopicUpdate on the Diagnosis and Surgical Treatment of Gynecological TumorsView all 8 articles
A newly modified nerve-sparing radical hysterectomy technique with analysis of short-term oncologic, surgical, and functional outcomes
Provisionally accepted
- 1Second Affiliated Hospital of Dalian Medical University, Dalian, China
- 2Dalian Medical University, Dalian, Liaoning, China
- 3Department of Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China
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Objective This study aims to investigate a newly modified approach to nerve-sparing radical hysterectomy. Subjects and Methods Pathological large-section staining of the entire paracolpium from specimens obtained after radical hysterectomy was performed to examine its structural composition and identify the course and distribution of the pelvic plexus and its branches. Based on the analysis of nerve pathways and locations, a total of 55 cases of modified nerve-sparing surgeries preserving pelvic autonomic function were conducted.Results All radical hysterectomies were performed in accordance with the principles of membrane anatomy. Postoperative pathological large-section staining of the paracolpium, combined with microscopic examination, revealed three distinct planes from ventral to dorsal: a vascular plane, consisting of the deep uterine vein and bladder venous plexus draining into the deep uterine vein; a neural plane, formed by the pelvic plexus and its nerve branches; and a ligamentous plane, consisting of the sacral ligament. In clinical practice, utilizing the three-plane structure of the paracolpium and medially lifting the vascular plane facilitated safe, reliable dissection, exposure, and preservation of pelvic autonomic nerve function.Through clinical practice, follow-up, and analysis of 55 cases, it was observed that combining the concept of membrane anatomy with the three-plane anatomical structure of the paracolpium not only enables nerve-sparing radical hysterectomy as a bloodless surgical procedure but also ensures optimal nerve preservation, favorable oncological outcomes, and a significant reduction in perioperative complications.Conclusion Guided by the principles of membrane anatomy and the three-plane theory of the paracolpium, nerve-sparing radical hysterectomy facilitates precise preservation of pelvic autonomic nerve function in a bloodless manner, while achieving favorable oncological outcomes.
Keywords: cervical cancer, Radical hysterectomy, Nerve-sparing, membrane bridge, Embryonic compartment
Received: 04 Jan 2025; Accepted: 12 May 2025.
Copyright: © 2025 Wang, Zhu, Li, Na, Han and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shichao Han, Second Affiliated Hospital of Dalian Medical University, Dalian, China
Jun Wang, Second Affiliated Hospital of Dalian Medical University, Dalian, China
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