Czy radykalna histerektomia uwzględniająca morfogenezę tkanek (total mesometrial resection-TMMR) z terapeutyczną limfadenektomią (therapeutic lymph node dissection-tLND) wg M.Höckel znajdzie swoje miejsce w chirurgicznym leczeniu raka szyjki macicy

Abstract

A radical hysterectomy with pelvic lymph node dissection is the standard operative treatment in patients with diagnosed IB-IIA degree by FIGO 2018 invasive uterine cervix carcinoma. \nA concept and technique of radical hysterectomy was created at the end of the 19th Century based on the then knowledge on the progression of neoplasms. In the space of years, in order to limit the scale of side effects, subsequent modifications of the radical hysterectomy technique appeared, however still on the basis of the same model of the neoplasm’s propagation concerning the accidental infiltration of surrounding tissues promoted by reduced mechanical resistance. \nIn 2003 Prof. M. Hockel was the first to present a new concept of radical hysterectomy, which originated in the studies on the local development of the tumour. \nIn comparison with the other methods of radical surgery, radical hysterectomy involving tissue morphogenesis (total mesometrial resection – TMMR) by M. Hockel with therapeutic lymph node dissection (tLND), apart from the maintenance of the oncologic efficacy range with concomitant conservation of the vegetative innervation, allows the improvement of a therapeutic index in tumours with unfavourable prognostic factors, at the same time generating a small number of post-operative complications. \nIt should also be noted that the fundamental feature distinguishing tLND-assisted TMMR from the classic radical hysterectomy is a possibility to avoid a supplementary radiotherapy with no effect on future outcomes.