主动脉旁淋巴结清扫术（PALND）是一种广泛使用的治疗方法，但会引起许多并发症。本研究旨在通过与传统 PALND 比较在妇科恶性肿瘤中评估保留神经主动脉旁淋巴结清扫术 (NSPALND) 的疗效和安全性，并证明定位上腹下丛 (SHP) 是否有助于显露主动脉旁淋巴结。这是对2020年1月至2022年12月在浙江省肿瘤医院接受主动脉旁淋巴结清扫术的患者的回顾性研究。根据是否保留神经分为NSPALND组和PALND组。对手术、功能和肿瘤学结果进行评估。共入组 43 例患者，其中 20 例患者接受 NSPALND，23 例患者接受 PALND。 20例NSPALND均通过定位SHP成功显露主动脉旁神经。 NSPALND组术后肛门排气时间显着短于PALND组（2.5与4天，p=0.006），且NSPALND组急性肠梗阻发生率显着低于PALND组。 PALND 组（10% 与 39%，p=0.029）。两组在导尿时间、尿潴留、排尿困难、切除淋巴结数量、主动脉旁复发率等方面均无差异。NSPALND可显着降低急性肠梗阻发生率，改善术后并发症。肠道功能的运作。定位 SHP 并将其用作解剖标志来揭示主动脉旁神经是可行的。其确切的临床价值有待进一步研究。© 2025。亚洲妇科肿瘤学会、韩国妇科肿瘤学会、日本妇科肿瘤学会。

Para-aortic lymph node dissection (PALND) is a widely used treatment that causes many complications. This study is to evaluate the efficacy and safety of nerve-sparing para-aortic lymph node dissection (NSPALND) by comparing it with conventional PALND in gynecological malignancies and to prove whether locating the superior hypogastric plexus (SHP) can help reveal the para-aortic nerves.This is a retrospective study of the patients who underwent para-aortic lymphadenectomy from January 2020 to December 2022 at Zhejiang Cancer Hospital. All of them were divided into NSPALND and PALND groups according to whether or not nerve-sparing was performed. The surgical, functional and oncological outcomes were evaluated.There were 43 patients enrolled, of which, 20 patients underwent NSPALND and 23 patients underwent PALND. The para-aortic nerves were successfully revealed by locating the SHP in all 20 cases of NSPALND. The post-operative anal exhaust time in the NSPALND group was significantly shorter than that in the PALND group (2.5 vs. 4 days, p=0.006), and the incidence of acute intestinal obstruction in the NSPALND group was significantly lower than that in the PALND group (10% vs. 39%, p=0.029). There was no difference between the two groups in terms of catheterization duration, urinary retention, dysuria, as well as the number of lymph nodes removed and the para-aortic recurrence rate.NSPALND can significantly reduce the rate of acute intestinal obstruction and improve post-operative intestinal function. Locating the SHP and using it as an anatomical landmark to reveal the para-aortic nerves is feasible. Its exact clinical value needs to be further studied.© 2025. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.