TY - JOUR
T1 - Radical hysterectomy
T2 - An anatomic evaluation of parametrial dissection
AU - Yabuki, Yoshihiko
AU - Asamoto, Akihiro
AU - Hoshiba, Tsutomu
AU - Nishimoto, Hideaki
AU - Nishikawa, Yukiko
AU - Nakajima, Takao
PY - 2000/4
Y1 - 2000/4
N2 - Objectives. This study was designed to demonstrate a reduction in the amount of blood loss for vesicouterine ligament dissection and to investigate the intrapelvic autonomic nerve pathway and its preservation by means of anatomic analysis. Methods. The anchoring mechanism of the pelvic viscera to the pelvic wall was divided into a supporting system facing laterally and a suspensory system facing dorsoventrally. An operative procedure was designed in which both systems were separated and dissected independently. Results. Between the two systems, an artificial space was developed, which required a new dissection method for the parametrium and revealed a new anatomic pathway for the ureter and autonomic nerve. The amount of blood loss (mean ± SD) during dissection of the vesicouterine ligament was ultimately 260.1 ± 114.8 ml. Postoperatively, the maximum capacity of the bladder was 393.9 ± 40.4 ml, maximum detrusor pressure 6.3 ± 4.1 cm H2O, mean compliance > 10 ml/cm H2O, residual urine 23.8 ± 9.4 ml, and maximum flow rate 25. ± 8 2.2 ml/s, respectively. Conclusion. A new classification for the parametrium and its dissection method have been established. Development of this new operative procedure has also contributed to a decrease in blood loss and preservation of bladder function. (C) 2000 Academic Press.
AB - Objectives. This study was designed to demonstrate a reduction in the amount of blood loss for vesicouterine ligament dissection and to investigate the intrapelvic autonomic nerve pathway and its preservation by means of anatomic analysis. Methods. The anchoring mechanism of the pelvic viscera to the pelvic wall was divided into a supporting system facing laterally and a suspensory system facing dorsoventrally. An operative procedure was designed in which both systems were separated and dissected independently. Results. Between the two systems, an artificial space was developed, which required a new dissection method for the parametrium and revealed a new anatomic pathway for the ureter and autonomic nerve. The amount of blood loss (mean ± SD) during dissection of the vesicouterine ligament was ultimately 260.1 ± 114.8 ml. Postoperatively, the maximum capacity of the bladder was 393.9 ± 40.4 ml, maximum detrusor pressure 6.3 ± 4.1 cm H2O, mean compliance > 10 ml/cm H2O, residual urine 23.8 ± 9.4 ml, and maximum flow rate 25. ± 8 2.2 ml/s, respectively. Conclusion. A new classification for the parametrium and its dissection method have been established. Development of this new operative procedure has also contributed to a decrease in blood loss and preservation of bladder function. (C) 2000 Academic Press.
UR - http://www.scopus.com/inward/record.url?scp=0034006787&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034006787&partnerID=8YFLogxK
U2 - 10.1006/gyno.1999.5723
DO - 10.1006/gyno.1999.5723
M3 - Article
C2 - 10739705
AN - SCOPUS:0034006787
SN - 0090-8258
VL - 77
SP - 155
EP - 163
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 1
ER -