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Nerve Sparing in Radical Surgery for Early-Stage Cervical Cancer: Yes We Should!
  1. Cornelis D. de Kroon, MD, PhD,
  2. Katja N. Gaarenstroom, MD, PhD,
  3. Mariette I. E. van Poelgeest, MD, PhD,
  4. Alexander A. Peters, MD, PhD and
  5. J. Baptist Trimbos, MD, PhD
  1. Department of Gynaecology, Leiden University Medical Center, RC Leiden, the Netherlands.
  1. Address correspondence and reprint requests to Cornelis D. de Kroon, MD, PhD, Department of Gynaecology, Leiden University Medical Center, PO Box 9700, 2300 RC Leiden, the Netherlands. E-mail: cordekroon{at}lumc.nl.

Abstract

Radical hysterectomy with pelvic lymphadenectomy is considered to be the cornerstone in the treatment of early-stage cervical cancer. Although survival in early-stage cervical cancer is up to 95%, long-term morbidity with regard to bladder, bowel, and sexual function is considerable. Damage to the pelvic autonomic nerves may be the cause of these long-term complications following radical hysterectomy. Some authors have presented surgical techniques to preserve the autonomic nerves (ie, the hypogastric nerves and the splanchnic nerves) without compromising radicality. Safety, efficacy, and the surgical techniques of nerve-sparing radical hysterectomy are presented, and data confirm that whenever the decision is made to perform a radical hysterectomy, nerve-sparing techniques should be considered.

  • Cervical cancer
  • Nerve-sparing radical hysterectomy
  • Autonomic nervous system
  • Long-term morbidity
  • Quality of life

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Footnotes

  • The authors have no conflicts of interest to report.

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