IMR Press / EJGO / Volume 36 / Issue 1 / DOI: 10.12892/ejgo2211.2015

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Review
Nerve sparing radical hysterectomy in early stage cervical cancer. Latest developments and review of the literature
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1 Fourth Department of Gynecology and Obstetrics, Aristotle University of Thessaloniki, Thessaloniki (Greece)
2 Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Luebeck (Germany)
3 Second Department of Gynecology, St. Savvas Anticancer, Oncological Hospital, Athens (Greece)
4 Department of Gynecologic Oncology, St. Loukas Hospital, Thessaloniki (Greece)
Eur. J. Gynaecol. Oncol. 2015, 36(1), 5–9; https://doi.org/10.12892/ejgo2211.2015
Published: 10 February 2015
Abstract

Background: Cervical cancer is the second most common malignancy of the female genital tract worldwide. Radical hysterectomy with pelvic lymphadenectomy exemplifies the treatment of choice for early stage disease, whereas even if it is performed by gynaecologist-oncologist, still has the drawback of significant postoperative morbidity, especially for urinary bladder function. Nerve-sparing radical hysterectomy (NSRH) is a technique in which the neural part of the cardinal ligament which encloses the inferior hypogastric plexus, as well as the bladder branch (distal part of the plexus), remains intact. By this way, the bladder’s innervation is safe and its functional recovery is more rapid. There is sufficient data to support the feasibility of the technique via laparotomy and laparoscopy, as well as the effectiveness related to the postoperative bladder dysfunction compared to conventional radical hysterectomy. On the other hand, the evidence related to survival outcomes is weak and derives from non-randomized trials. However, the low rate of local relapses after NSRH in early stage disease (IA2-IB1) with tumor diameter less than two cm makes the procedure suitable for this group of patients. Conclusion: According to the current evidence NSRH seems to be a suitable technique for gynaecologist-oncologist familiar with the method in early stage cervical cancer. It is a technique which improves significantly postoperative bladder recovery and the patients’ quality of life (QoL), without compromising the oncological standard.
Keywords
Radical hysterectomy
Nerve-sparing
Laparoscopy
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