A 40-year-old woman with Stage IB1 squamous cell carcinoma of the cervix is planned for a Piver-Rutledge Type III (Wertheim-Meigs) radical hysterectomy. Which structures are removed as part of this operation?
- A Uterus, parametrium, upper vagina, and pelvic lymph nodes ✓
- B Uterus with both ovaries and tubes, leaving parametrium intact
- C Uterus, parametrium, upper vagina, pelvic lymph nodes, bladder, and rectum
- D Uterus and upper vagina only, with sampling of para-aortic nodes
Correct answer: A. Uterus, parametrium, upper vagina, and pelvic lymph nodes
Explanation
Type III radical hysterectomy entails wide excision of the uterus with the entire parametrium and paravaginal tissues, removal of 2 cm or the upper third of the vagina, and systematic pelvic lymphadenectomy. The ovaries are routinely conserved in premenopausal women with squamous histology because ovarian metastasis is rare. Removal of bladder and rectum defines pelvic exenteration, which makes option C a description of a different operation entirely.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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