Zusammenfassung
Fragestellung
Fragestellung: Kann der therapeutische Index bei der operativen Behandlung des Zervixkarzinoms verbessert
werden?
Methodik
Methodik: Liposuction-assistierte Untersuchungen der topographischen Neuroanatomie im Becken
weiblicher Körperspender bildeten die Grundlage für die Entwicklung der nervenschonenden
radikalen Hysterektomie [11].
Ergebnisse
Ergebnisse: Die nervenschonende radikale Hysterektomietechnik unterscheidet sich von der traditionellen
Wertheim-Meigs-Operation durch: 1. Resektion von zusätzlichem Risikogewebe, insbesondere
im inferioren posterioren Parametrium sowie lateral und dorsal der großen Beckengefäße;
2. Reduktion des Gewebetraumas durch Präparation in durch die Embryonalentwicklung
vorgegebenen Ebenen; 3. Darstellen und Schonen wesentlicher Anteile des autonomen
Beckennervensystems.
Schlussfolgerung
Schlussfolgerung: Die Umsetzung neuer anatomischer und tumorbiologischer Erkenntnisse in die Technik
der nervenschonenden radikalen Hysterektomie eröffnet eine Möglichkeit, die operative
Behandlung des Zervixkarzinoms zu verbessern.
Abstract
Objective
Objective: To improve the therapeutic index of the surgical treatment of cervical cancer.
Methods
Methods: The technique of nerve-sparing radical hysterectomy was developed based on liposuction-assisted
neuroanatomical studies of the female pelvis.
Results
Results: Compared with conventional radical hysterectomy, the nerve-sparing procedure permitted
the resection of more parametrial tissue, particularly in the inferior and posterior
parametrium as well as lateral to and behind the major vessels. Tissue trauma was
reduced by dissection along embryologically preformed planes. Major portions of the
autonomic pelvic nerve supply were dissected out and preserved.
Conclusions
Conclusions: The application of new anatomical and tumor biological findings in nerve-sparing
radical hysterectomy may improve the surgical treatment of cervical cancer.
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Univ.-Prof. Dr. Dr. Michael Höckel
Universitätsfrauenklinik
Philipp-Rosenthal-Strasse 55
04103 Leipzig
