{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T23:59:07Z","timestamp":1774396747538,"version":"3.50.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to investigate a newly modified approach to nerve-sparing radical hysterectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Pathological large-section staining of the entire paracolpium from specimens obtained after radical hysterectomy was performed to examine its structural composition and identify the course and distribution of the pelvic plexus and its branches. Based on the analysis of nerve pathways and locations, a total of 55 cases of modified nerve-sparing surgeries preserving pelvic autonomic function were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All radical hysterectomies were performed in accordance with the principles of membrane anatomy. Postoperative pathological large-section staining of the paracolpium, combined with microscopic examination, revealed three distinct planes from ventral to dorsal: a vascular plane, consisting of the deep uterine vein and bladder venous plexus draining into the deep uterine vein; a neural plane, formed by the pelvic plexus and its nerve branches; and a ligamentous plane, consisting of the sacral ligament. In clinical practice, utilizing the three-plane structure of the paracolpium and medially lifting the vascular plane facilitated safe, reliable dissection, exposure, and preservation of pelvic autonomic nerve function.Through clinical practice, follow-up, and analysis of 55 cases, it was observed that combining the concept of membrane anatomy with the three-plane anatomical structure of the paracolpium not only enables nerve-sparing radical hysterectomy as a bloodless surgical procedure but also ensures optimal nerve preservation, favorable oncological outcomes, and a significant reduction in perioperative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Guided by the principles of membrane anatomy and the three-plane theory of the paracolpium, nerve-sparing radical hysterectomy facilitates precise preservation of pelvic autonomic nerve function in a bloodless manner, while achieving favorable oncological outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1555483","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T04:14:10Z","timestamp":1749010450000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["A newly modified nerve-sparing radical hysterectomy technique with analysis of short-term oncologic, surgical, and functional outcomes"],"prefix":"10.3389","volume":"15","author":[{"given":"Shichao","family":"Han","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyou","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinming","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Na","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1002\/ijgo.v152.1","article-title":"Cervical cancer in low-income countries: a Bangladeshi perspective","volume":"152","author":"Hoque","year":"2021","journal-title":"Int J Gynaecol Obstet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-606X.21.05008-9","article-title":"Early prediction of urinary retention following radical hysterectomy by 18FFDG PET\/CT imaging","volume":"75","author":"Davidson","year":"2023","journal-title":"Minerva Obstet Gynecol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.10.061","article-title":"Late morbidity following nerve-sparing radical hysterectomy","volume":"116","author":"Cibula","year":"2010","journal-title":"Gynecol Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1272\/jnms.JNMS.2021_88-503","article-title":"Effectiveness and long-term outcomes of nerve-sparing radical hysterectomy for cervical cancer","volume":"88","author":"Yamamoto","year":"2021","journal-title":"J Nippon Med Sch"},{"key":"B5","doi-asserted-by":"publisher","first-page":"102696","DOI":"10.1016\/j.eclinm.2024.102696","article-title":"Oncologic outcomes after Total Mesometrial Resection (TMMR) or treatment according to current international guidelines in FIGO (2009) stages IB1-IIB cervical cancer: an observational cohort study","volume":"73","author":"Falconer","year":"2024","journal-title":"EClinicalMedicine"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-11-211","article-title":"Definition of compartment-based radical surgery in uterine cancer: radical hysterectomy in cervical cancer as 'total mesometrial resection (TMMR)' by M H\u00f6ckel translated to robotic surgery (rTMMR)","volume":"11","author":"Kimmig","year":"2013","journal-title":"World J Surg Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.19538\/j.fk2024020116","article-title":"Clinical application of embryonic compartment hysterectomy in the treatment of cervical cancer","volume":"40","author":"Na","year":"2024","journal-title":"Chin J Pract Gynecology Obstetrics"},{"key":"B8","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1007\/s11701-024-01982-y","article-title":"Surgical procedures and techniques in robot-assisted uterine artery-preserving radical trachelectomy","volume":"18","author":"Han","year":"2024","journal-title":"J Robot Surg"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.12180\/j.issn.2096-7721.2023.05.009","article-title":"Application and prospect of membrane anatomy in robot-assisted laparoscopic cervical cancer surgery","volume":"4","author":"Han","year":"2023","journal-title":"J Robotic Surg"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(05)70324-7","article-title":"Association between the mesenchymal compartment of uterovaginal organogenesis and local tumour spread in stage IB-IIB cervical carcinoma: a prospective study","volume":"6","author":"H\u00f6ckel","year":"2005","journal-title":"Lancet Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/S1470-2045(08)70074-3","article-title":"Classification of radical hysterectomy","volume":"9","author":"Querleu","year":"2008","journal-title":"Lancet Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-017-6031-z","article-title":"2017 Update on the querleu\u2013Morrow classification of radical hysterectomy","volume":"24","author":"Querleu","year":"2017","journal-title":"Ann Surg Oncol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.ijsu.2016.08.001","article-title":"Laparoscopic nerve-sparing radical hysterectomy for bulky cervical cancer (\u22656 cm) after neoadjuvant chemotherapy: A multicenter prospective cohort study","volume":"34","author":"Yang","year":"2016","journal-title":"Int J Surg"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70100-7","article-title":"Resection of the embryologically defined uterovaginal (M\u00fcllerian) compartment and pelvic control in patients with cervical cancer: a prospective analysis","volume":"10","author":"H\u00f6ckel","year":"2009","journal-title":"Lancet Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2010.06.019","article-title":"Vulvar field resection: Novel approach to the surgical treatment of vulvar cancer based on ontogenetic anatomy","volume":"119","author":"H\u00f6ckel","year":"2010","journal-title":"Gynecol Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.04.040","article-title":"Ontogenetic anatomy of the distal vagina: Relevance for local tumor spread and implications for cancer surgery","volume":"122","author":"H\u00f6ckel","year":"2011","journal-title":"Gynecol Oncol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1136\/ijgc-00009577-200311000-00010","article-title":"Total mesometrial resection: high resolution nerve-sparing radical hysterectomy based on developmentally defined surgical anatomy","volume":"13","author":"H\u00f6ckel","year":"2003","journal-title":"Int J Gynecol Cancer"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1466921","article-title":"Robot-assisted M\u00fcllerian compartment resection for cervical cancer","volume":"14","author":"Li","year":"2024","journal-title":"Front Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1555483\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T04:14:12Z","timestamp":1749010452000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1555483\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,4]]},"references-count":18,"alternative-id":["10.3389\/fonc.2025.1555483"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1555483","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,4]]},"article-number":"1555483"}}