Masaki Z, Kinoshita N, Iguchi A, Komine S, Ichigi Y, Hujiyama C, Yoshinaga H, Sato S, Kuratomi K
Department of Surgery, Saga Medical School.
Nihon Hinyokika Gakkai Zasshi. 1992 Apr;83(4):488-92. doi: 10.5980/jpnjurol1989.83.488.
We report a new operative technique for plastic correction of uretero-pelvic junction (UPJ) obstruction: dismembered spiral flap pyeloplasty. It is similar to the method described by Culp & DeWeerd in that a flap is made spirally but different in that UPJ is detached. Relatively a long and wide spiral (oblique) flap, the apex of which directs cranioventrally or craniodorsally, is made using the dilated pelvis. The apex of the flap is reflected downward and anastomosed to the split ureteral end. Because the flap is made obliquely, one side of the flap base is approximated to the opposite pelvic margin; this helps to make gradual funnelling of pelvio-ureteric transition. The method seems to be fit for cases with considerably long stenosis of UPJ and with the UPJ locating relatively close to the medial margin of the renal parenchyma. Seven of 26 pyeloplasties were done by this method in our institute, and all the 7 cases had satisfactory results.
我们报告一种用于肾盂输尿管连接部（UPJ）梗阻整形矫正的新手术技术：离断螺旋瓣肾盂成形术。它与Culp和DeWeerd所描述的方法类似，即制作螺旋状皮瓣，但不同之处在于离断了UPJ。利用扩张的肾盂制作一个相对长且宽的螺旋（斜形）皮瓣，其尖端指向颅腹侧或颅背侧。将皮瓣尖端向下翻转并与劈开的输尿管末端吻合。由于皮瓣是斜形制作的，皮瓣基部的一侧与相对的肾盂边缘靠近；这有助于使肾盂输尿管移行部逐渐形成漏斗状。该方法似乎适用于UPJ存在相当长狭窄且UPJ相对靠近肾实质内侧边缘的病例。在我们研究所，26例肾盂成形术中7例采用了该方法，所有7例均取得了满意的效果。
