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

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 s...

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Autores principales: Kostov, Stoyan, Selçuk, Ilker, Watrowski, Rafał, Kornovski, Yavor, Yalçın, Hakan, Slavchev, Stanislav, Ivanova, Yonka, Dzhenkov, Deyan, Yordanov, Angel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870911/
https://www.ncbi.nlm.nih.gov/pubmed/35204609
http://dx.doi.org/10.3390/diagnostics12020519
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author Kostov, Stoyan
Selçuk, Ilker
Watrowski, Rafał
Kornovski, Yavor
Yalçın, Hakan
Slavchev, Stanislav
Ivanova, Yonka
Dzhenkov, Deyan
Yordanov, Angel
author_facet Kostov, Stoyan
Selçuk, Ilker
Watrowski, Rafał
Kornovski, Yavor
Yalçın, Hakan
Slavchev, Stanislav
Ivanova, Yonka
Dzhenkov, Deyan
Yordanov, Angel
author_sort Kostov, Stoyan
collection PubMed
description 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.
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spelling pubmed-88709112022-02-25 Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space Kostov, Stoyan Selçuk, Ilker Watrowski, Rafał Kornovski, Yavor Yalçın, Hakan Slavchev, Stanislav Ivanova, Yonka Dzhenkov, Deyan Yordanov, Angel Diagnostics (Basel) Article 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. MDPI 2022-02-17 /pmc/articles/PMC8870911/ /pubmed/35204609 http://dx.doi.org/10.3390/diagnostics12020519 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kostov, Stoyan
Selçuk, Ilker
Watrowski, Rafał
Kornovski, Yavor
Yalçın, Hakan
Slavchev, Stanislav
Ivanova, Yonka
Dzhenkov, Deyan
Yordanov, Angel
Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space
title Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space
title_full Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space
title_fullStr Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space
title_full_unstemmed Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space
title_short Pelvic Sidewall Anatomy in Gynecologic Oncology—New Insights into a Potential Avascular Space
title_sort pelvic sidewall anatomy in gynecologic oncology—new insights into a potential avascular space
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870911/
https://www.ncbi.nlm.nih.gov/pubmed/35204609
http://dx.doi.org/10.3390/diagnostics12020519
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