A newly modified nerve-sparing radical hysterectomy technique with analysis of short-term oncologic, surgical, and functional outcomes

ObjectiveThis study aims to investigate a newly modified approach to nerve-sparing radical hysterectomy.Subjects and MethodsPathological large-section staining of the entire paracolpium from specimens obtained after radical hysterectomy was performed to examine its structural composition and identif...

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Main Authors: Shichao Han, Xinyou Wang, Jinming Zhu, Ya Li, Jing Na, Jun Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1555483/full
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author Shichao Han
Shichao Han
Xinyou Wang
Xinyou Wang
Jinming Zhu
Ya Li
Ya Li
Jing Na
Jing Na
Jun Wang
Jun Wang
author_facet Shichao Han
Shichao Han
Xinyou Wang
Xinyou Wang
Jinming Zhu
Ya Li
Ya Li
Jing Na
Jing Na
Jun Wang
Jun Wang
author_sort Shichao Han
collection DOAJ
description ObjectiveThis study aims to investigate a newly modified approach to nerve-sparing radical hysterectomy.Subjects and MethodsPathological 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.ResultsAll 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.ConclusionGuided 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.
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spelling doaj-art-dd386e69341b41e4b5c0f52914a8fcdc2025-08-20T03:19:20ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.15554831555483A newly modified nerve-sparing radical hysterectomy technique with analysis of short-term oncologic, surgical, and functional outcomesShichao Han0Shichao Han1Xinyou Wang2Xinyou Wang3Jinming Zhu4Ya Li5Ya Li6Jing Na7Jing Na8Jun Wang9Jun Wang10Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Obstetrics and Gynecology, the Second Clinical College of Dalian Medical University, Dalian, ChinaDepartment of Gynecology and Obstetrics, The Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Obstetrics and Gynecology, the Second Clinical College of Dalian Medical University, Dalian, ChinaOncology Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, ChinaDepartment of Gynecology and Obstetrics, The Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Obstetrics and Gynecology, the Second Clinical College of Dalian Medical University, Dalian, ChinaDepartment of Gynecology and Obstetrics, The Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Obstetrics and Gynecology, the Second Clinical College of Dalian Medical University, Dalian, ChinaDepartment of Gynecology and Obstetrics, The Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Obstetrics and Gynecology, the Second Clinical College of Dalian Medical University, Dalian, ChinaObjectiveThis study aims to investigate a newly modified approach to nerve-sparing radical hysterectomy.Subjects and MethodsPathological 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.ResultsAll 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.ConclusionGuided 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.https://www.frontiersin.org/articles/10.3389/fonc.2025.1555483/fullcervical cancerradical hysterectomynerve-sparingmembrane bridgeembryonic compartment
spellingShingle Shichao Han
Shichao Han
Xinyou Wang
Xinyou Wang
Jinming Zhu
Ya Li
Ya Li
Jing Na
Jing Na
Jun Wang
Jun Wang
A newly modified nerve-sparing radical hysterectomy technique with analysis of short-term oncologic, surgical, and functional outcomes
Frontiers in Oncology
cervical cancer
radical hysterectomy
nerve-sparing
membrane bridge
embryonic compartment
title A newly modified nerve-sparing radical hysterectomy technique with analysis of short-term oncologic, surgical, and functional outcomes
title_full A newly modified nerve-sparing radical hysterectomy technique with analysis of short-term oncologic, surgical, and functional outcomes
title_fullStr A newly modified nerve-sparing radical hysterectomy technique with analysis of short-term oncologic, surgical, and functional outcomes
title_full_unstemmed A newly modified nerve-sparing radical hysterectomy technique with analysis of short-term oncologic, surgical, and functional outcomes
title_short A newly modified nerve-sparing radical hysterectomy technique with analysis of short-term oncologic, surgical, and functional outcomes
title_sort newly modified nerve sparing radical hysterectomy technique with analysis of short term oncologic surgical and functional outcomes
topic cervical cancer
radical hysterectomy
nerve-sparing
membrane bridge
embryonic compartment
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1555483/full
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