Therapie der ureteropelvinen Stenose im Erwachsenenalter

Zusammenfassung

Die ureteropelvine Stenose, synonym Subpelvin- oder Nierenbeckenabgangsstenose, beschreibt eine Obstruktion im Bereich des pyeloureteralen Übergangs, in deren Folge eine renale Harnabflussstörung resultiert, die es zu behandeln gilt.

Seit der Erstbeschreibung der Pyeloplastik durch Trendelenburg 1886 und der erfolgreichen Etablierung durch Anderson und Hynes 1949 haben sich die Behandlungsstrategien der Nierenbeckenplastik vor allem in den letzten zwei Jahrzehnten weiterentwickelt. Zwar gilt die offene Pyeloplastik nach wie vor als Goldstandard, doch wird diese heutzutage durch moderne minimal-invasive Techniken ergänzt. Dies inkludiert u. a. die laparoskopische Pyeloplastik, laparoskopische Single-Site Pyeloplastik, roboter-assistierte Pyeloplastik, roboter-assistierte Single-Site Pyeloplastik sowie die Endopyelotomie.

Dieser Artikel gibt eine Übersicht über die Therapie der ureteropelvinen Stenose sowie das Komplikationsmanagement der Pyeloplastik im Erwachsenenalter.

Abstract

Ureteropelvic stenosis, also known as ureteropelvic junction obstruction, is an obstruction in the region of the pyeloureteral junction resulting in a urinary discharge disorder of the renal pelvis, which requires treatment.

Since the first description of pyeloplasty by Trendelenburg in 1886 and the successful establishment of open pyeloplasty by Anderson and Hynes in 1949, the treatment strategies for ureteropelvic junction obstruction have developed considerably, especially in the last two decades. Although open pyeloplasty is still considered to be the gold standard, this concept is supplemented by modern minimally-invasive techniques today. These include laparoscopic pyeloplasty, laparoscopic single-site pyeloplasty, robot-assisted pyeloplasty, robot-assisted single-site pyeloplasty, and endopyelotomy.

This article provides an overview of the different treatment strategies for ureteropelvic junction obstruction as well as the complication management of pyeloplasty in adult age.

Schlüsselwörter

Ureteropelvinstenose - Erwachsenenalter - Pyeloplastik - Komplikationen.

Keywords

Ureteropelvic stenosis - adult age - pyeloplasty - complications

^* S. Mühlstädt und J. Kranz sind gleichberechtigte Erstautoren.

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