Department of Urology, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
Nat Rev Urol. 2014 Nov;11(11):629-38. doi: 10.1038/nrurol.2014.240. Epub 2014 Oct 7.
Ureteropelvic junction obstruction (UPJO) is characterized by impaired flow of urine from the renal pelvis to the ureter. Untreated disease can result in renal impairment making effective management crucial. A combination of CT imaging and diuretic renography is typically used for diagnosis. CT is the investigation of choice for obtaining anatomical information about UPJO and can help to identify potential causes. Diuretic renography is best for providing functional information about UPJO. A variety of open and minimally invasive surgical techniques are available for treatment of UPJO. Traditionally open pyeloplasty has been the standard of care but minimally invasive surgical techniques have become increasingly popular. Endopyelotomy has a lower success rate than other modalities (42-90% depending on the approach), but is associated with reduced pain and shorter convalescence. Laparoscopic pyeloplasty and robot-assisted pyeloplasty have similar success rates to open pyeloplasty (>90%), with the additional advantages of significantly reduced morbidity and shorter convalescence. More long-term outcome data for minimally invasive surgical techniques are awaited.
肾盂输尿管连接部梗阻（UPJO）的特征是尿液从肾盂到输尿管的流动受阻。未治疗的疾病可能导致肾功能损害，因此有效治疗至关重要。通常采用 CT 成像和利尿剂肾图来进行诊断。CT 是获取 UPJO 解剖信息的首选检查方法，有助于识别潜在的病因。利尿剂肾图最适合提供 UPJO 的功能信息。有多种开放和微创的手术技术可用于治疗 UPJO。传统上，开放肾盂成形术是标准的治疗方法，但微创技术越来越受欢迎。内切开术的成功率低于其他方法（根据手术方法的不同，成功率为 42-90%），但与疼痛减轻和恢复期缩短有关。腹腔镜肾盂成形术和机器人辅助肾盂成形术的成功率与开放肾盂成形术相似（>90%），具有显著降低发病率和恢复期缩短的额外优势。微创技术的更多长期预后数据正在等待中。
