Trimbos J B, Maas C P, Deruiter M C, Kenter G G
Afd. Gynaecologie, Leids Universitair Medisch Centrum, Postbus 9600, 2300 RC Leiden.
Ned Tijdschr Geneeskd. 2003 Jul 12;147(28):1344-7.
Autonomous pelvic nerves are essential for bladder and rectum function as well as sexuality. These nerves are usually permanent damaged during radical oncological surgery and this results in urological, sexual and proctological morbidity. Japanese surgeons have paved the way for surgical approaches to dissect these nerves during surgery and leave them intact. At the Department of Gynaecology of the Leiden University Medical Center, the Netherlands, a new surgical technique has been developed to spare the autonomous pelvic nerves during radical hysterectomy. In this procedure the lateral parts of the sacro-uterine ligament, through which the N. hypogastricus passes bilaterally, are left intact. The initial results of this nerve-sparing surgical technique during radical hysterectomy seem to be promising. The operation was easy to perform, with almost no extra blood loss and an extra operating time of just 10-15 minutes. Postoperative recovery of the bladder function occurred after a mean period of 9 days.
自主盆腔神经对于膀胱、直肠功能以及性功能至关重要。这些神经在根治性肿瘤手术中通常会受到永久性损伤,进而导致泌尿、性和直肠方面的发病情况。日本外科医生为手术中解剖这些神经并使其保持完整的手术方法铺平了道路。在荷兰莱顿大学医学中心妇科,已开发出一种新的手术技术,在根治性子宫切除术中保留自主盆腔神经。在此手术过程中,双侧腹下神经穿过的骶子宫韧带外侧部分保持完整。这种根治性子宫切除术中保留神经的手术技术的初步结果似乎很有前景。该手术操作简便,几乎没有额外失血,额外手术时间仅为10 - 15分钟。膀胱功能术后平均9天恢复。