Classical and nerve-sparing radical hysterectomy: An evaluation of the nerve trauma in cardinal ligament
Classical and nerve-sparing radical hysterectomy: An evaluation of the nerve trauma in cardinal ligament
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DOI：
10.1016/j.ygyno.2011.12.448
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发表时间：
2012-04-01
影响因子：
4.7
通讯作者：
Huang, Lei
中科院分区：
文献类型：
--
作者：
Chen, Chunlin;Li, Weili;Huang, Lei
目标.本研究评价了保留神经的根治性子宫切除术（NSRH）与根治性子宫切除术（RH）中自主神经损伤和主韧带（CL）内血管切除的组织病理学和临床结局。25例FIGO Ib 1-IIa期宫颈癌患者接受了RH（n = 13）或NSRH（n = 12）。测量取出的CL长度。从CL的近端、中间和远端段收集活检标本并固定。使用不同的标记物进行细胞化学分析：酪氨酸羟化酶用于交感神经;血管活性肠多肽用于副交感神经; CD 34用于血管; D2-40用于淋巴管。采用生物体视学参数容积密度（Vv）定量测定CL组分，比较RH组和NSRH组术后排便、排尿功能及2年无病生存率。神经主要分布于CL的中、远段。RH组交感神经和副交感神经标记物的Vv均大于NSRH组（P
Objectives. This study evaluated histopathology and clinical outcome of autonomic nerve trauma and vessels removal within the cardinal ligament (CL) during nerve-sparing radical hysterectomy (NSRH) compared with radical hysterectomy (RH).Methods. 25 women with FIGO stage Ib1-IIa cervical cancer underwent RH (n = 13) or NSRH (n = 12). Removed CLs lengths were measured. Biopsies were collected from the proximal, middle and distal segment of CLs and fixed. Different markers were used for immunohistochemisty analysis: tyrosine hydroxylase for sympathetic nerves; vasoactive intestinal polypeptide for parasympathetic nerves; CD34 for blood vessels; and D2-40 for lymphatic vessels. The volume density (Vv), a parameter of biological stereology, was used to quantitatively measure CL components, while post-operative functions, such as defecation, micturition and two-year disease free survival in RH and NSRH groups were compared.Results. The nerves mainly existed in the middle and distal segments of CLs. The Vv was greater in RH compared with NSRH for both sympathetic and parasympathetic nerve markers (P