During a radical hysterectomy for Stage IB1 cervical cancer, the surgeon removes the uterus, parametrial tissue dissected to the level of the ureter after unroofing the ureteric tunnel, 1.5 to 2 cm of upper vagina, and performs pelvic lymphadenectomy. In the Querleu-Morrow classification this operation corresponds to:

• A Type A, extrafascial hysterectomy
• B Type B1, partial resection of paracervix at the ureter
• C Type D2, laterally extended resection with lymphovascular resection
• D Type C1, radical hysterectomy with nerve sparing ✓

Explanation

Querleu-Morrow Type D removes the parametrium at the level of the ureter including the ureteric tunnel dissection, with removal of 1.5 to 2 cm of vagina; when the autonomic hypogastric nerves are deliberately preserved it becomes D1, equivalent to Piver-Rutledge Type III, the standard for Stage IB1 to IB2. Type A is simple extrafascial removal, Type B stops medial to the ureter, and Type C adds resection of vessels and lateral structures.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.