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Anatomy of the superior hypogastric plexus and its application in nerve-sparing paraaortic lymphadenectomy
, , , ,
Affiliations- Department of Anatomy, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-Gu, 06591 Seoul, Korea, Republic Of
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Abstract
Background: The purpose of this study was to clarify the anatomy of the superior hypogastric plexus, which would contribute to advancement of nerve-sparing paraaortic lymphadenectomy.
Materials and methods: Eighteen cadavers were dissected and morphometrically analysed based on photographic images. Anatomical landmarks such as aortic bifurcation, transitional points of abdominal aorta to bilateral common iliac arteries, and cross point of the right ureter and pelvic brim, and cross point of sigmoid mesentery and pelvic brim were selected as reference points.
Results: The left lowest lumbar splanchnic nerve was located more laterally to transitional point of abdominal aorta to in 11/18 specimens, whereas the right lowest lumbar splanchnic nerve passed onto the right transitional point in only one specimen. The lowest lumbar splanchnic nerves or the superior hypogastric plexus covered the aortic bifurcation in 11/18 specimens. The superior hypogastric plexus was separate from the cross point of right ureter and pelvic brim as well as cross point of sigmoid mesentery and pelvic brim.
Conclusions: The superior hypogastric plexus is at risk of injury during paraaortic lymphadenectomy because of its topography. Preservation of the superior hypogastric plexus regarding its anatomic basis during paraaortic lymphadenectomy is required.
Abstract
Background: The purpose of this study was to clarify the anatomy of the superior hypogastric plexus, which would contribute to advancement of nerve-sparing paraaortic lymphadenectomy.
Materials and methods: Eighteen cadavers were dissected and morphometrically analysed based on photographic images. Anatomical landmarks such as aortic bifurcation, transitional points of abdominal aorta to bilateral common iliac arteries, and cross point of the right ureter and pelvic brim, and cross point of sigmoid mesentery and pelvic brim were selected as reference points.
Results: The left lowest lumbar splanchnic nerve was located more laterally to transitional point of abdominal aorta to in 11/18 specimens, whereas the right lowest lumbar splanchnic nerve passed onto the right transitional point in only one specimen. The lowest lumbar splanchnic nerves or the superior hypogastric plexus covered the aortic bifurcation in 11/18 specimens. The superior hypogastric plexus was separate from the cross point of right ureter and pelvic brim as well as cross point of sigmoid mesentery and pelvic brim.
Conclusions: The superior hypogastric plexus is at risk of injury during paraaortic lymphadenectomy because of its topography. Preservation of the superior hypogastric plexus regarding its anatomic basis during paraaortic lymphadenectomy is required.
Keywords
lowest lumbar splanchnic nerves, nerve-sparing surgery, superior hypogastric plexus
About this articleTitle
Anatomy of the superior hypogastric plexus and its application in nerve-sparing paraaortic lymphadenectomy
Journal
Issue
Article type
Original article
Pages
70-75
Published online
2020-03-18
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1707
Article views/downloads
3440
DOI
Pubmed
Bibliographic record
Folia Morphol 2021;80(1):70-75.
Keywords
lowest lumbar splanchnic nerves
nerve-sparing surgery
superior hypogastric plexus
Authors
H. Kim
Y. S. Nam
U.-Y. Lee
I.-B. Kim
Y.-S. Kim
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