Systematic Anatomical Description of the Female Pelvic Retroperitoneum in Cadavers

Официальное название

Systematic Anatomical Description of the Female Pelvic Retroperitoneum in Cadavers: A Descriptive Study for Gynecologic Surgery

Обзор

This observational descriptive cadaveric study aims to describe the main anatomical relationships of the female pelvic retroperitoneum using standardized anatomical dissection. Adult female cadavers obtained from an institutional body donation program will undergo pelvic retroperitoneal dissection. Ten predefined anatomical relationships involving the ureter, pelvic vessels and nerves will be evaluated using a standardized anatomical checklist. Anatomical variability will be described for each item. Standardized photographs will also be obtained to develop an anatomical atlas for educational purposes.

Подробное описание

This is an observational, descriptive cadaveric study designed to characterize the main anatomical relationships of the female pelvic retroperitoneum with direct application to gynecologic surgery.

The study will be conducted using adult female cadavers obtained from an institutional body donation program. Approximately 20 cadavers will be included, depending on availability, providing a total of 40 hemipelves. Each hemipelvis will be considered an independent unit of analysis.

Standardized anatomical dissections of the pelvic retroperitoneum will be performed following a predefined protocol. The main anatomical structures relevant to gynecologic surgery will be identified, including the pelvic ureter, iliac vessels and their branches, obturator nerve, and other predefined anatomical landmarks.

Each hemipelvis will be evaluated using a standardized 10-item anatomical checklist. For every item, the reference anatomical pattern will be classified as present ("Yes"), absent ("No"), or not evaluable ("Not evaluable"). Anatomical variability will be calculated as the proportion of anatomical variants among all evaluable hemipelves for each item.

Standardized photographic documentation will be obtained throughout the dissections. Anatomical variants will be qualitatively described and illustrated whenever possible.

Statistical analysis will be descriptive. Categorical variables will be presented as absolute frequencies and percentages. Anatomical variability will be reported for each checklist item, excluding non-evaluable observations from the denominator.

This study does not involve living human participants, clinical interventions, or identifiable personal data. All procedures will be conducted in accordance with institutional and ethical standards governing the use of donated human bodies for research and education.

The expected outcome is a systematic description of the principal anatomical relationships of the female pelvic retroperitoneum and their anatomical variability, together with the development of a photographic anatomical atlas to support surgical training and gynecologic education.

Вмешательства

• Другое Anatomical Dissection
  Standardized pelvic retroperitoneal dissection with completion of a 10-item anatomical checklist, observations and photographic documentation.

Первичные конечные точки

• Frequency of anatomical variation [Срок оценки: Baseline]

Вторичные конечные точки (1)

• Development of an anatomical atlas [Срок оценки: Baseline]

Критерии участия

Критерии включения

• Female cadavers from an institutional body donation program
• Age ≥ 18 years at time of death
• Adequate preservation of pelvic and abdominal retroperitoneal structures
• Anatomical integrity allowing identification of the pelvic ureter, iliac vessels and their main branches, obturator nerve, and other structures included in the anatomical checklist.
• Availability of both hemipelves for comparative analysis
• Authorization for research use according to institutional body donation regulations

Критерии исключения

• Male cadavers
• Prior major pelvic or abdominal surgery significantly altering retroperitoneal anatomy (e.g., hysterectomy, lymphadenectomy, vascular surgery)
• History of pelvic or abdominal radiotherapy
• Advanced pelvic or abdominal malignancy with retroperitoneal involvement
• Severe trauma affecting pelvic or abdominal anatomy
• Poor preservation or significant tissue degradation
• Absence of one or both hemipelves
• Advanced pregnancy at time of death

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Модель наблюдения

Другое

Центры проведения

Испания · 2 центра

• Universitat de Barcelona - Department of Anatomy and Human Embryology — Barcelona
• Universitat de Barcelona - Department of Anatomy and Human Embryology — Barcelona

Публикации

• Cibula D, Abu-Rustum NR. Pelvic lymphadenectomy in cervical cancer--surgical anatomy and proposal for a new classification system. Gynecol Oncol. 2010 Jan;116(1):33-7. doi: 10.1016/j.ygyno.2009.09.003. Epub 2009 Oct 17. PMID 19837449
• Sanna B, Henry BM, Vikse J, Skinningsrud B, Pekala JR, Walocha JA, Cirocchi R, Tomaszewski KA. The prevalence and morphology of the corona mortis (Crown of death): A meta-analysis with implications in abdominal wall and pelvic surgery. Injury. 2018 Feb;49(2):302-308. doi: 10.1016/j.injury.2017.12.007. Epub 2017 Dec 9. PMID 29241998
• Sienkiewicz-Zawilinska J, Zawilinski J, Kaythampilla LN, Jankiel M, Urbaniak J, Bereza T, Kowalski W, Loukas M, Walocha J. Autonomic nervous system of the pelvis - general overview. Folia Med Cracov. 2018;58(2):21-44. doi: 10.24425/fmc.2018.124656. PMID 30467432
• Ripperda CM, Jackson LA, Phelan JN, Carrick KS, Corton MM. Anatomic relationships of the pelvic autonomic nervous system in female cadavers: clinical applications to pelvic surgery. Am J Obstet Gynecol. 2017 Apr;216(4):388.e1-388.e7. doi: 10.1016/j.ajog.2016.12.002. Epub 2016 Dec 9. PMID 27956200
• Kostov S, Slavchev S, Dzhenkov D, Mitev D, Yordanov A. Avascular Spaces of the Female Pelvis-Clinical Applications in Obstetrics and Gynecology. J Clin Med. 2020 May 13;9(5):1460. doi: 10.3390/jcm9051460. PMID 32414119

Идентификаторы

NCT: NCT07522931 · UB-RETROPERITONEO-2026

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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