Streem S B
Department of Urology, Cleveland Clinic Foundation, Ohio, USA.
Urol Clin North Am. 1998 May;25(2):331-41. doi: 10.1016/s0094-0143(05)70022-7.
The indications to intervene for ureteropelvic junction (UPJ) obstruction have not changed despite the introduction of newer, less invasive techniques for definitive management. In contemporary practice, open operative intervention is still appropriate for those patients in whom alternative management has failed or is contraindicated, or for those in whom an unobstructed UPJ needs to be assured with the highest certainty--both immediately and with long-term follow-up. Although several techniques have been described for open operative reconstruction of an obstructed UPJ, a dismembered pyeloplasty has proven to be the most versatile, and should be a part of every urologist's treatment armamentarium. Alternative primary and salvage techniques for open operative reconstruction of the UPJ are also described in this article.
尽管出现了更新的、侵入性较小的确定性治疗技术，但输尿管肾盂连接部（UPJ）梗阻的干预指征并未改变。在当代实践中，对于那些替代治疗失败或存在禁忌证的患者，或者对于那些需要立即并通过长期随访以最高确定性确保UPJ无梗阻的患者，开放手术干预仍然是合适的。尽管已经描述了几种用于开放手术重建梗阻性UPJ的技术，但离断性肾盂成形术已被证明是最通用的，应该成为每位泌尿外科医生治疗手段的一部分。本文还描述了UPJ开放手术重建的替代初次和挽救技术。
