Poulakis V, Witzsch U, Schultheiss D, Rathert P, Becht E
Klinik für Urologie und Kinderurologie, Krankenhaus Nordwest der Stiftung Hospital zum Heiligen Geist, Akademisches Lehrkrankenhaus der Johann-Wolfgang-Goethe-Universität, Frankfurt a.M.
Urologe A. 2004 Dec;43(12):1544-59. doi: 10.1007/s00120-004-0663-x.
The first reconstructive procedure for ureteropelvic junction (UPJ) obstruction was performed by Trendelenburg in 1886. The important milestones in the reconstruction of UPJ are discussed and all available historical papers and reports since 1886 are reviewed. Kuster published the first successful dismembered pyeloplasty 5 years later, but his technique was prone to strictures. In 1892, the application of the Heineke-Mickulicz principle by Fenger resulted in bulking and kinking with obstruction. Plication of the renal pelvis, first introduced by Israel in 1896, was modified by Kelly in 1906. After the principle of the Finney pyloroplasty, von Lichtenberg designed his pyeloplasty in 1921, best suited to cases of high implantation of the ureter. Foley modified flap techniques, first introduced by Schwyzer in 1923 after the application of the Durante pyloroplasty principle, successfully to Y-V pyeloplasty in 1937. Culp and de-Weerd introduced the spiral flap in 1951. Scardino and Prince reported about the vertical flap in 1953. Patel published the extra-long spiral flap technique in 1982. In order to decrease the likelihood of stricture, Nesbit, in 1949, modified Kuster's procedure by utilizing an elliptic anastomosis. In the same year, Anderson and Hynes, published their technique. With the advent of endourology, several minimally invasive procedures were applied: antegrade or retrograde endopyelotomy, balloon dilation, and laparoscopic pyeloplasty. The concept of full-thickness incision of the narrow segment followed by prolonged stenting was first described in 1903 by Albarran and was popularized by Davis in 1943. Several basic principles must be applied in order to ensure successful repair: the resultant anastomosis should be widely patent, performed in a watertight fashion without tension. Endopyelotomy represents an alternative to open surgery.
1886年，特伦德伦堡首次实施了肾盂输尿管连接处（UPJ）梗阻的重建手术。本文讨论了UPJ重建的重要里程碑，并回顾了自1886年以来所有可获取的历史文献和报告。5年后，库斯特发表了首例成功的离断性肾盂成形术，但他的技术容易出现狭窄。1892年，芬格应用海涅克 - 米库利奇原理导致肾盂肿胀和扭结并伴有梗阻。肾盂折叠术由伊斯雷尔于1896年首次提出，1906年由凯利进行了改良。在芬尼幽门成形术的原理基础上，冯·利希滕贝格于1921年设计了他的肾盂成形术，最适合输尿管高位植入的病例。福利于1937年成功地将施维泽在1923年应用杜兰特幽门成形术原理后首次引入的皮瓣技术改良为Y - V肾盂成形术。卡尔普和德 - 韦尔德于1951年引入了螺旋皮瓣。斯卡迪诺和普林斯于1953年报道了垂直皮瓣。帕特尔于1982年发表了超长螺旋皮瓣技术。为了降低狭窄的可能性，内斯比特在1949年通过采用椭圆形吻合术对库斯特的手术进行了改良。同年，安德森和海恩斯发表了他们的技术。随着腔内泌尿外科的出现，应用了几种微创手术：顺行或逆行肾盂内切开术、球囊扩张术和腹腔镜肾盂成形术。狭窄段全层切开并延长支架置入的概念最早由阿尔巴兰于1903年描述，并于1943年由戴维斯推广。为确保修复成功，必须应用几个基本原则：最终的吻合口应广泛通畅，以无张力的防水方式进行。肾盂内切开术是开放手术的一种替代方法。
