Querleu Denis, Morrow C Paul
Department of Surgery, Institut Claudius Regaud, University Paul Sabatier, Toulouse, France.
Lancet Oncol. 2008 Mar;9(3):297-303. doi: 10.1016/S1470-2045(08)70074-3.
Since the first publications about surgery for cervical cancer, many radical procedures that accord with different degrees of radicality have been described and done. Here, we propose a basis for a new and simple classification for cervical-cancer surgery, taking into account the curative effect of surgery and adverse effects, such as bladder dysfunction. The international anatomical nomenclature is used where it applies. For simplification, the classification is based only on lateral extent of resection. We describe four types of radical hysterectomy (A-D), adding when necessary a few subtypes that consider nerve preservation and paracervical lymphadenectomy. Lymph-node dissection is considered separately: four levels (1-4) are defined according to corresponding arterial anatomy and radicality of the procedure. The classification applies to fertility-sparing surgery, and can be adapted to open, vaginal, laparoscopic, or robotic surgery. In the future, internationally standardised description of techniques for communication, comparison, clinical research, and quality control will be a basic part of every surgical procedure.
自从关于宫颈癌手术的首批出版物问世以来，已经描述并实施了许多符合不同根治程度的根治性手术。在此，我们提出一种新的、简单的宫颈癌手术分类依据，同时考虑手术的疗效以及诸如膀胱功能障碍等不良反应。在适用的情况下使用国际解剖学命名法。为简化起见，该分类仅基于切除的侧向范围。我们描述了四种根治性子宫切除术（A - D型），必要时添加一些考虑神经保留和宫颈旁淋巴结清扫的亚型。淋巴结清扫单独考虑：根据相应的动脉解剖结构和手术的根治程度定义了四个级别（1 - 4级）。该分类适用于保留生育功能的手术，并且可适用于开放手术、阴道手术、腹腔镜手术或机器人手术。未来，用于交流、比较、临床研究和质量控制的技术的国际标准化描述将成为每一项外科手术的基本组成部分。
