Nerve sparing in radical surgery for early-stage cervical cancer: yes we should!
Radical hysterectomy with pelvic lymphadenectomy is considered to be the cornerstone in the treatment of early-stage cervical cancer. Although survival in early-stage cervical cancer is up to 95%, long-term morbidity with regard to bladder, bowel, and sexual function is considerable. Damage to the pelvic autonomic nerves may be the cause of these long-term complications following radical hysterectomy. Some authors have presented surgical techniques to preserve the autonomic nerves (ie, the hypogastric nerves and the splanchnic nerves) without compromising radicality. Safety, efficacy, and the surgical techniques of nerve-sparing radical hysterectomy are presented, and data confirm that whenever the decision is made to perform a radical hysterectomy, nerve-sparing techniques should be considered.
de Kroon
Cornelis D
CD
Department of Gynaecology, Leiden University Medical Center, RC Leiden, the Netherlands. cordekroon@lumc.nl
Gaarenstroom
Katja N
KN
van Poelgeest
Mariette I E
MI
Peters
Alexander A
AA
Trimbos
J Baptist
JB
D005260:Female; D006801:Humans; D007001:Hypogastric Plexus / Q000293:injuries; D007044:Hysterectomy / Q000379:methods*; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D010388:Pelvis / Q000294:innervation / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D013153:Splanchnic Nerves / Q000293:injuries; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*