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Classification of Radical Hysterectomy

  • Denis Querleu
Chapter

Abstract

The popular Piver-Rutledge-Smith classification of radical hysterectomy has become inadapted as a result of the development of less radical techniques, of paracervical lymphadenectomy, of extended resections at the pelvic sidewall, and of fertility-preserving and of nerve-sparing techniques. Its shortcomings are overcome by using the simpler Querleu-Morrow classification, which considers only the lateral extent of the excision, using stable anatomical landmarks described according to the international anatomical nomenclature. Four types, A to D, are defined. In type A, the paracervix (“cardinal ligament”) is excised halfway between the cervix and the ureter. In type B, the paracervix is excised at the ureter, without (B1) or with (B2) paracervical lymphadenectomy. In type C the paracervix is excised at the internal iliac vessels, with (C1) or without (C2) preservation of the autonomic nerves. Type D includes different types of laterally extended resections mainly indicated for recurrent disease. The new classification is adapted to vaginal surgery, is compatible with asymmetrical surgeries, and accepts tailored vaginal excision. The description of classical radical hysterectomy, type C in the Querleu-Morrow classification, has been refined by Cibula.

Keywords

Cervical cancer Radical hysterectomy 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Denis Querleu
    • 1
  1. 1.Department of SurgeryInstitut BergoniéBordeauxFrance

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