根治性子宫切除术是早期宫颈癌患者的标准手术治疗方法。它于 100 多年前首次推出。从那时起，人们描述了各种不同的激进程序，其激进程度有所不同。在实际解剖学中可以清楚地看到不一致之处，这被定义为手术造成的伪影。此外，在盆腔结缔组织和空间的术语方面，手术的差异最为显着。尽管存在这些争议，该手术仍被广泛实施并在大多数宫颈癌手术治疗指南中得到实施。然而，已经报道了一种不同且独特的宫颈癌手术治疗概念。它基于个体发生解剖学，并根据其胚胎发育来绘制成熟生物体中的任何组织。该理论在早期宫颈癌的临床应用是全系膜切除术。本文旨在描述和比较根治性子宫切除术（C1/C2 型）和全系膜切除术的解剖学和手术基础知识。详细强调了两种手术在术语、切除线和手术平面方面的差异。还描述了盆腔自主神经的手术解剖结构及其手术解剖。这是第一篇比较经典解剖学和个体解剖学在宫颈癌手术治疗方面的差异的文章。两种手术的临床数据、肿瘤学结果以及新辅助和辅助治疗不是本文的主题。

A radical hysterectomy is the standard method of surgical treatment for patients with early-stage cancer of the uterine cervix. It was first introduced more than 100 years ago. Since then, various and many different radical procedures, which diverge in terms of radicality, have been described. Inconsistencies are clearly seen in practical anatomy, which were defined as surgically created artifacts. Moreover, the disparity of the procedure is most notable regarding the terminology of pelvic connective tissues and spaces. Despite these controversies, the procedure is widely performed and implemented in the majority of guidelines for the surgical treatment of cancer of the uterine cervix. However, a different and unique concept of surgical treatment of cervical cancer has been reported. It is based on ontogenetic anatomy and maps any tissue in the mature organism according to its embryologic development. The clinical implementation of this theory in the context of early cervical cancer is total mesometrial resection. The present article aims to describe and compare the anatomical and surgical basics of a radical hysterectomy (type C1/C2) and total mesometrial resection. Discrepancies regarding the terminology, resection lines, and surgical planes of both procedures are highlighted in detail. The surgical anatomy of the pelvic autonomic nerves and its surgical dissection is also delineated. This is the first article that compares the discrepancy of classic anatomy and ontogenic anatomy regarding surgical treatment of cancer of the uterine cervix. Clinical data, oncological outcome, and neoadjuvant and adjuvant treatment regarding both procedures are not the topic of the present article.