Pelvic lymphadenectomy in cervical cancer--surgical anatomy and proposal for a new classification system
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články
PubMed
19837449
DOI
10.1016/j.ygyno.2009.09.003
PII: S0090-8258(09)00674-X
Knihovny.cz E-zdroje
- MeSH
- lidé MeSH
- lymfadenektomie klasifikace metody normy MeSH
- lymfatické uzliny anatomie a histologie patologie chirurgie MeSH
- nádory děložního čípku patologie chirurgie MeSH
- pánev anatomie a histologie chirurgie MeSH
- terminologie jako téma MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Pelvic lymphadenectomy is an integral component of gynecologic cancer surgery, yet there is a lack of standardization in the terminology used, the extent of the procedure, and the definition of anatomic landmarks. This lack of standardization if corrected will likely facilitate a more clear communication and analysis of outcomes from various institutions, and reduce confusion to trainees about the procedure being performed. METHODS: We summarize the anatomic data concerning pelvic lymphatic drainage; describe the procedure based on clearly defined anatomic landmarks; and finally propose a new classification system to facilitate standardization, communication, and comparison of results. The accompanying video demonstrates the anatomic landmarks. RESULTS: We list and define four commonly used terms related to pelvic lymph node harvesting: sentinel node mapping, excision of bulky nodes, pelvic lymph node sampling, and systematic pelvic lymphadenectomy. We list the five specific anatomic regions of the pelvic lymphatic basin: external iliac, obturator, internal iliac, common iliac, and presacral. We highlight the important neural structures located in regions of the pelvic lymphadenectomy: genitofemoral nerve, obturator nerve, cranial part of the lumbosacral plexus, hypogastric plexus, and splanchnic nerves. Finally, we propose a new, four-part classification system of types of pelvic lymph node dissection. CONCLUSION: In this report and video, we demonstrate anatomy and offer a new classification system for pelvic lymphadenectomy.
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