Lutzeyer W
Urologe A. 1985 May;24(3):127-31.
Open routine operations on the kidney and the renal calyces have diminished in favour of endourological methods. Renal and renal pelvis calculi as well as ureteral calculi are rarely approached through open operation. Selective indications for operation depend on special situations and anatomy, since complications such as injury to large abdominal wall nerves, the peritoneum or the pleura present no problem for the skilled surgeon. The control of a sudden and serious hemorrhage coming from the renal hilus or the vena cava surely is an important complication, which should not be underestimated, and stopping such hemorrhages requires knowledge of the peritoneal stepwise method of stopping a hemorrhage. Secondary and multiple operations on the kidney need a clear tactical treatment concept. This is presented in a four-phase-concept. To avoid or control intra- and postoperative complications when operacting on the renal calyces or the upper ureter it is still important to respect the old rules of temporary diversion of urine and to know reconstructive methods of the urinary tract.
肾脏和肾盏的开放常规手术已逐渐减少,而更倾向于采用腔内泌尿外科方法。肾和肾盂结石以及输尿管结石很少通过开放手术处理。手术的选择性指征取决于特殊情况和解剖结构,因为对于技术熟练的外科医生来说,诸如损伤大的腹壁神经、腹膜或胸膜等并发症并非难题。控制来自肾蒂或腔静脉的突发严重出血无疑是一个不应被低估的重要并发症,而制止此类出血需要掌握腹膜逐步止血法的知识。肾脏的二次手术和多次手术需要清晰的战术治疗理念。这在一个四阶段理念中有所阐述。在对肾盏或上段输尿管进行手术时,为避免或控制术中及术后并发症,遵循尿液暂时改道的旧规则并了解尿路重建方法仍然很重要。