title: Nerve-sparing radical hysterectomy in cervical cancer: evolution of concepts.
abstract: OBJECTIVE
  This paper reviews the evolution of concepts concerning the nerve-sparing radical hysterectomy (NSRH) in cervical cancer.
  
  
  METHODS
  Research studies published between 1991 and 2006 were reviewed.
  
  
  RESULTS
  Significant progress has been made in understanding the neuroanatomy and the neurophysiology of autonomic pelvic plexus. The ideal surgical management of cervical cancer patients should be tailored on the basis of prognostic factors and quality of life. Within the discussion concerning the optimal level of radicality of hysterectomy, which is still controversial, the new concept of NSRH has to be considered in order to reduce morbidity without compromising the oncological disease control. Surgical strategies have been developed to spare the autonomic functions with promising results.
  
  
  CONCLUSIONS
  To date, there is a growing body of data about NSRH in cervical cancer. However, there is not yet a consensus concerning to which part of uterine support ligaments a NS approach should be directed.
authors.affiliation: Department of Gynecologic Oncology, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Raspagliesi
authors.forename: Antonino
authors.initials: A
authors.lastname: Ditto
authors.forename: Francesco
authors.initials: F
authors.lastname: Hanozet
authors.forename: Fabio
authors.initials: F
authors.lastname: Martinelli
authors.forename: Eugenio
authors.initials: E
authors.lastname: Solima
authors.forename: Flavia
authors.initials: F
authors.lastname: Zanaboni
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kusamura
authors.forename: Rosanna
authors.initials: R
authors.lastname: Fontanelli
mesh_terms: D002584:Cervix Uteri / Q000294:innervation / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods* / Q000639:trends; D002583:Uterine Cervical Neoplasms / Q000601:surgery*