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Abdominal hysterectomy – spatial model of surgical resection

Michał Zdrodowski1, Paweł Knapp1, Alicja Szyłejko2, Piotr Bernaczyk3

Affiliacja i adres do korespondencji
Curr Gynecol Oncol 2015, 13 (4), p. 245–255
DOI: 10.15557/CGO.2015.0027
Streszczenie
The paper presents current views on radical hysterectomy classification, including descriptive comments regarding the surgical extent and medical indications. Radical hysterectomy remains the primary surgical procedure in gynecologic oncology and is of particular importance for the treatment of patients with cervical cancer. A number of publications of the last decades failed to anatomically define radical hysterectomy – it was assumed that the issue is familiar based on Wertheim’s description. Attempts to systematize the therapeutic procedure resulted in a classification adapted to the current state of knowledge. Classification of radical hysterectomy published by Querleu and Morrow’s and later modified by Cibula and Abu-Rustum is the most current and commonly accepted system. The authors systematized previous, less precise classification, thus allowing to standardize terminology used in surgery reports, medical publications, clinical protocols and randomized trials. The uniqueness of this concept is due to the use of a three-dimensional model – Cibula and Abu-Rustum describe pelvic anatomical landmarks, allowing for a proper spatial orientation at different stages of surgical procedure, as well as the borders of resection for different anatomical elements (parametrium in particular). Standardization of radical hysterectomy procedure is also a key element in the education of gynecologic oncologists. Therefore, the presented classification should be known and used in everyday surgical practice.
Słowa kluczowe
hysterectomy, parametrium, classification