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Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space

Authors :
Stoyan Kostov
Ilker Selçuk
Rafał Watrowski
Yavor Kornovski
Hakan Yalçın
Stanislav Slavchev
Yonka Ivanova
Deyan Dzhenkov
Angel Yordanov
Source :
Diagnostics, Vol 12, Iss 2, p 519 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

The surgical treatment of gynecological malignancies is, except for tumors diagnosed at the earliest stages and patients’ desire for fertility preservation, not limited to only the affected organ. In cases of metastatic iliac lymph nodes, gynecological tumors or recurrences located near the pelvic sidewall, oncogynecologists should dissect tissues in that region. Moreover, surgery of deep infiltrating endometriosis, e.g., within the sacral plexus, or oncological procedures, such as a laterally extended endoplevic resection or a laterally extended parametrectomy, often require a dissection of the pelvic sidewall. Dissection should be meticulous, and detailed knowledge of anatomy is mandatory. There are many controversies among authors regarding the terminology in the pelvic sidewall. In particular, several imprecise or confusing definitions exist in regard to the region located medially to the psoas major muscle. Therefore, after discussing the anatomy of the pelvic sidewall and the commonly used terminology, we define a new term and boundaries of a potential avascular space, the medial psoas space. Contrary to the variety of earlier definitions, the proposed boundaries relate to a truly avascular space and could help surgeons to avoid complications resulting from misleading anatomical descriptions. Additionally, describing the clear boundaries of and possible anatomical variations in the medial psoas space may urge oncogynecologists to consider different approaches during surgery. The purpose of the present study is to describe the anatomy of the pelvic sidewall and the applications of the medial psoas space in gynecologic oncology.

Details

Language :
English
ISSN :
20754418
Volume :
12
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Diagnostics
Publication Type :
Academic Journal
Accession number :
edsdoj.121cc3caac29414084d1fa91570d469f
Document Type :
article
Full Text :
https://doi.org/10.3390/diagnostics12020519