Stühler V, Bedke J, Stenzl A
Klinik für Urologie, Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland.
Urologe A. 2019 Jun;58(6):651-657. doi: 10.1007/s00120-019-0944-z.
Defects in ureteral continuity and function can originate from various etiologies such as stricture, radiotherapy, tuberculosis, tumor, trauma or perforation due to iatrogenic injury. The surgical options for the management of ureteral defects are complex and depend on the location of the defect. The aim of the surgical management of ureteral stricture is the reconstruction of an anti-refluxive and nonobstructive flow of urine to preserve kidney function. There are numerous possibilities for the reconstruction of ureteral defects ranging from ureteroneocystostomy with or without psoas-hitch- or Boari-flap to ileal ureteral replacement. Nearly all these techniques can either be done in open surgery or in a laparoscopically or robotic-assisted manner. The technique of robotic-assisted reconstruction of ureteral defects is challenging but offers a great opportunity. The aim of this article is to provide an overview of current surgical procedures in ureteric reconstruction.
输尿管连续性和功能的缺陷可源于多种病因,如狭窄、放疗、结核、肿瘤、创伤或医源性损伤导致的穿孔。输尿管缺损的手术治疗方案复杂,取决于缺损的位置。输尿管狭窄手术治疗的目的是重建抗反流且无梗阻的尿液流动,以保护肾功能。输尿管缺损的重建方法有很多种,从带或不带腰大肌固定或鲍里皮瓣的输尿管膀胱吻合术到回肠代输尿管术。几乎所有这些技术都可以通过开放手术、腹腔镜手术或机器人辅助手术完成。机器人辅助输尿管缺损重建技术具有挑战性,但提供了一个很好的机会。本文旨在概述目前输尿管重建的手术方法。