Surgery and OncologySurgery and OncologyХирургия и онкология2949-5857Publishing House ABV Press27710.17650/2220-3478-2019-9-1-11-18LITERATURE REVIEWОБЗОР ЛИТЕРАТУРЫSurgical anatomy of the pelvis: role of parametriumХирургическая анатомия малого таза: значение параметрияNikogosyanS. O.НикогосянС. О.
Russian Federation

Седа Овиковна Никогосян

115478 Москва, Каширское шоссе, 23

ss.gestalt@gmail.comhttps://orcid.org/0000-0002-9303-8379GordeevS. S.ГордеевС. С.
Russian Federation

23 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 23

TumanyanA. O.ТуманянА. О.
Russian Federation

23 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 23

MalikhovA. G.МалиховА. Г.
Russian Federation

23 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 23

ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииN.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России160620199111181606201916062019Copyright ©; 2019, Nikogosyan S.O., Gordeev S.S., Tumanyan A.O., Malikhov A.G.Copyright ©; 2019, Никогосян С.О., Гордеев С.С., Туманян А.О., Малихов А.Г.2019Nikogosyan S.O., Gordeev S.S., Tumanyan A.O., Malikhov A.G.Никогосян С.О., Гордеев С.С., Туманян А.О., Малихов А.Г.https://creativecommons.org/licenses/by/4.0https://onco-surgery.info/jour/article/view/277

Parametrium is a unique structure. Its definition has undergone significant changes throughout the evolution of concepts on the anatomy, embryology, and surgery of the pelvis. Knowledge of the parametrium anatomy is very important not only for surgeons dealing with the female reproductive system, but also for surgeons involved in the treatment of rectal cancer. For example, an outdated anatomical term “lateral ligaments of the rectum” is still widely used by gynecologic oncologists and is considered as a part of the parametrium. Combination surgeries for rectal cancer in women often involve the structures of parametrium. This paper reviews the history of studying the parametrium, its embryology, evolution of anatomical concepts, and their association with the development of pelvic surgery. We also propose allocating additional layers of the parametrium in order to make anatomical description closer to surgical practice.

Параметрий — уникальная структура. Его определение претерпевало значительные изменения в процессе эволюции представлений об анатомии, эмбриологии и хирургии малого таза. Несмотря на то что наибольшую роль он играет в хирургии органов женской репродуктивной системы, знание его строения очень важно и для хирургов, занимающихся лечением рака прямой кишки. Так, устаревший анатомический термин «боковые связки прямой кишки» широко используется онкогинекологами и трактуется как часть параметрия. При выполнении комбинированных операций по поводу рака прямой кишки у женщин наиболее часто вовлекаются структуры, входящие в состав параметрия. В статье представлен обзор истории изучения параметрия, его эмбриологии, эволюции анатомических представлений и их связи с развитием хирургии малого таза. Также предложено выделение дополнительных этажей параметрия, что в большей степени по сравнению с классическими определениями позволяет приблизить анатомическое описание к особенностям хирургической практики.

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