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Embryological Development and Topographic Anatomy of Pelvic Compartments—Surgical Relevance for Pelvic Lymphonodectomy

Background: The oncological outcome of surgery for the treatment of pelvic malignancies can be improved by performing pelvic lymphonodectomy. However, the extent and regions of lymph node harvest are debated and require profound knowledge of anatomy in order to avoid collateral damage. Methods: The...

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Autores principales: Bayer, Andreas, Heinze, Tillmann, Alkatout, Ibrahim, Osmonov, Daniar, Stelzner, Sigmar, Wedel, Thilo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916954/
https://www.ncbi.nlm.nih.gov/pubmed/33670197
http://dx.doi.org/10.3390/jcm10040708
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author Bayer, Andreas
Heinze, Tillmann
Alkatout, Ibrahim
Osmonov, Daniar
Stelzner, Sigmar
Wedel, Thilo
author_facet Bayer, Andreas
Heinze, Tillmann
Alkatout, Ibrahim
Osmonov, Daniar
Stelzner, Sigmar
Wedel, Thilo
author_sort Bayer, Andreas
collection PubMed
description Background: The oncological outcome of surgery for the treatment of pelvic malignancies can be improved by performing pelvic lymphonodectomy. However, the extent and regions of lymph node harvest are debated and require profound knowledge of anatomy in order to avoid collateral damage. Methods: The embryological development and topographic anatomy of pelvic compartments in relation to pelvic lymphonodectomy for rectal, uterine, and prostate cancer are reviewed. Based on pre-dissected anatomical specimens, lymph node regions and drainage routes of the posterior and urogenital pelvic compartments are described in both genders. Anatomical landmarks are highlighted to identify structures at risk of injury during pelvic lymphonodectomy. Results: The ontogenesis of urogenital and anorectal compartments and their lymphatic supply are key factors for adequate lymphonodectomy, and have led to compartment-based surgical resection strategies. However, pelvic lymphonodectomy bears the risk of injury to somatic and autonomic nerves, vessels, and organs, depending on the regions and extent of surgery. Conclusion: Embryologically defined, compartment-based resection of pelvic malignancies and their lymphatic drainage routes are based on clearly delineated anatomical landmarks, which permit template-oriented pelvic lymphonodectomy. Comprehensive knowledge of pelvic anatomy, the exchange of surgical concepts between specialties, and minimally invasive techniques will optimize pelvic lymphonodectomy and reduce complications.
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spelling pubmed-79169542021-03-01 Embryological Development and Topographic Anatomy of Pelvic Compartments—Surgical Relevance for Pelvic Lymphonodectomy Bayer, Andreas Heinze, Tillmann Alkatout, Ibrahim Osmonov, Daniar Stelzner, Sigmar Wedel, Thilo J Clin Med Article Background: The oncological outcome of surgery for the treatment of pelvic malignancies can be improved by performing pelvic lymphonodectomy. However, the extent and regions of lymph node harvest are debated and require profound knowledge of anatomy in order to avoid collateral damage. Methods: The embryological development and topographic anatomy of pelvic compartments in relation to pelvic lymphonodectomy for rectal, uterine, and prostate cancer are reviewed. Based on pre-dissected anatomical specimens, lymph node regions and drainage routes of the posterior and urogenital pelvic compartments are described in both genders. Anatomical landmarks are highlighted to identify structures at risk of injury during pelvic lymphonodectomy. Results: The ontogenesis of urogenital and anorectal compartments and their lymphatic supply are key factors for adequate lymphonodectomy, and have led to compartment-based surgical resection strategies. However, pelvic lymphonodectomy bears the risk of injury to somatic and autonomic nerves, vessels, and organs, depending on the regions and extent of surgery. Conclusion: Embryologically defined, compartment-based resection of pelvic malignancies and their lymphatic drainage routes are based on clearly delineated anatomical landmarks, which permit template-oriented pelvic lymphonodectomy. Comprehensive knowledge of pelvic anatomy, the exchange of surgical concepts between specialties, and minimally invasive techniques will optimize pelvic lymphonodectomy and reduce complications. MDPI 2021-02-11 /pmc/articles/PMC7916954/ /pubmed/33670197 http://dx.doi.org/10.3390/jcm10040708 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bayer, Andreas
Heinze, Tillmann
Alkatout, Ibrahim
Osmonov, Daniar
Stelzner, Sigmar
Wedel, Thilo
Embryological Development and Topographic Anatomy of Pelvic Compartments—Surgical Relevance for Pelvic Lymphonodectomy
title Embryological Development and Topographic Anatomy of Pelvic Compartments—Surgical Relevance for Pelvic Lymphonodectomy
title_full Embryological Development and Topographic Anatomy of Pelvic Compartments—Surgical Relevance for Pelvic Lymphonodectomy
title_fullStr Embryological Development and Topographic Anatomy of Pelvic Compartments—Surgical Relevance for Pelvic Lymphonodectomy
title_full_unstemmed Embryological Development and Topographic Anatomy of Pelvic Compartments—Surgical Relevance for Pelvic Lymphonodectomy
title_short Embryological Development and Topographic Anatomy of Pelvic Compartments—Surgical Relevance for Pelvic Lymphonodectomy
title_sort embryological development and topographic anatomy of pelvic compartments—surgical relevance for pelvic lymphonodectomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916954/
https://www.ncbi.nlm.nih.gov/pubmed/33670197
http://dx.doi.org/10.3390/jcm10040708
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