title: Lymphatic and nerve distribution throughout the parametrium.
abstract: BACKGROUND
  Our objective was to concomitantly assess distribution of lymphatic and nerve structures in the parametrium.
  
  
  METHODS
  Twenty hemipelvises from ten fresh cadavers were dissected to differentiate between, three different parts of the parametrium: the lateral parametrium, the proximal and the distal part of the posterior parametrium. Histologic and immunofluorescence analyses of nerve and lymphatic structures were performed using NSE and LYVE-1 staining, respectively. The percentage of structures was independently scored as 0 (0%), 1 (1-20%), 2 (20-50%), 3 (50-80%), 4 (>80%).
  
  
  RESULTS
  The lateral parametrium and the proximal part of the posterior parametrium contained both nerve (scored 2.25 and 2.50, respectively) and lymphatic (scored 2.50 and 2.00, respectively) structures. The distal part of the posterior parametrium also contained numerous nerve structures (scored 2.00) but lymphatic structures were rare (scored 0.88). No difference in nerve distribution was found according to the parts of parametrium while a significantly lower distribution of lymphatic vessels was observed in the distal part of the posterior parametrium (p=0.03).
  
  
  CONCLUSIONS
  The distal part of the posterior parametrium is of high nerve density and low lymphatic density raising the issue as to whether it should be removed during radical hysterectomy.
authors.affiliation: UMRS 872, Centre de Recherche des Cordeliers, 15 rue de l'école de médecine, 75006 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Bonneau
authors.forename: A
authors.initials: A
authors.lastname: Cortez
authors.forename: R
authors.initials: R
authors.lastname: Lis
authors.forename: M
authors.initials: M
authors.lastname: Mirshahi
authors.forename: A
authors.initials: A
authors.lastname: Fauconnier
authors.forename: M
authors.initials: M
authors.lastname: Ballester
authors.forename: E
authors.initials: E
authors.lastname: Daraï
authors.forename: C
authors.initials: C
authors.lastname: Touboul
mesh_terms: D001956:Broad Ligament / Q000033:anatomy & histology* / Q000166:cytology / Q000294:innervation* / Q000601:surgery; D002102:Cadaver; D005260:Female; D005455:Fluorescent Antibody Technique; D005557:Formaldehyde; D006801:Humans; D007044:Hysterectomy; D008208:Lymphatic System / Q000033:anatomy & histology* / Q000166:cytology; D011108:Polymers; D016707:Tissue Fixation; D014513:Ureter / Q000033:anatomy & histology / Q000294:innervation
chemical_list: D011108:Polymers; D005557:Formaldehyde; C003043:paraform
keywords: Anatomy; Cervical cancer; Lymph node; Nerve; Parametrectomy; Radical hysterectomy