[Lymphatic drainage of the uterus. Preliminary results of an experimental study]

We carried out an experimental study on the lymphatic drainage of the uterus in 11 female cadavers. We performed 5 injections of a colored fluid in the corpus uterinum and 6 in the cervix. We observed 2 main routes along the external iliac vessels. The first was anterior and drains the lower limb. The second is medial and posterior to the external iliac vessels and drained the uterus (2.4 lymph nodes/side). The number and location of the lymph nodes varied between subjects but also in the same subject (45.5% of cases). The cervix was essentially drained to lymph nodes located on the posterior aspect of the external iliac vein, especially near the hypogastric artery origin. We did not observe any direct connexion between the cervix and the para-aortic area. The corpus uterinum was drained to the lymph nodes located in the lateral part of the parametrium and or under the external iliac vein. One other main route ran along the infudibulo-pelvic ligament. These findings confirm that the first lymph nodes metastases of the cervical carcinoma are under the external iliac vein. and particularly near the hypogastric artery. On the other hand, endometrial carcinomas spread along two lymphatic connections: one extending to the external iliac area and another to the para-aortic area. These results have to be considered in order to define lymphadenectomy margins for these cancers.