Update Harnleiterrekonstruktion 2024
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Update Harnleiterrekonstruktion 2024. / Hook, Sophia; Gross, Andreas J.; Netsch, Christopher; Becker, Benedikt; Filmar, Simon; Vetterlein, Malte W.; Kluth, Luis A.; Rosenbaum, Clemens M.
in: UROLOGE, Jahrgang 63, Nr. 1, 01.2024, S. 25-33.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Update Harnleiterrekonstruktion 2024
AU - Hook, Sophia
AU - Gross, Andreas J.
AU - Netsch, Christopher
AU - Becker, Benedikt
AU - Filmar, Simon
AU - Vetterlein, Malte W.
AU - Kluth, Luis A.
AU - Rosenbaum, Clemens M.
N1 - © 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
PY - 2024/1
Y1 - 2024/1
N2 - Ureteral strictures can occur along the entire course of the ureter and have many different causes. Factors involved in the development include, among other things, congenital anomalies, iatrogenic injuries during endoscopic as well as open or minimally invasive visceral surgical, gynecological, and urological procedures as well as prior radiation therapy. Planning treatment for ureteral strictures requires a detailed assessment of stricture and patient characteristics. Given the various options for ureteral reconstruction, various methods must be considered for each patient. Short-segment proximal strictures and strictures at the pyeloureteral junction are typically surgically managed with Anderson-Hynes pyeloplasty. End-to-end anastomosis can be performed for short-segment proximal and middle ureteral strictures. Distal strictures are treated with ureteroneocystostomy and are often combined with a Boari and/or Psoas Hitch flap. Particularly, the treatment of long-segment strictures in the proximal and middle ureter remain a surgical challenge. The use of bowel interposition is an established treatment option for this, offering good functional results but also potential associated complications. Robot-assisted surgery is increasingly becoming a minimally invasive treatment alternative to reduce hospital stays and optimize postoperative recovery. However, open surgical ureteral reconstruction remains an established procedure, especially after multiple previous abdominal operations.
AB - Ureteral strictures can occur along the entire course of the ureter and have many different causes. Factors involved in the development include, among other things, congenital anomalies, iatrogenic injuries during endoscopic as well as open or minimally invasive visceral surgical, gynecological, and urological procedures as well as prior radiation therapy. Planning treatment for ureteral strictures requires a detailed assessment of stricture and patient characteristics. Given the various options for ureteral reconstruction, various methods must be considered for each patient. Short-segment proximal strictures and strictures at the pyeloureteral junction are typically surgically managed with Anderson-Hynes pyeloplasty. End-to-end anastomosis can be performed for short-segment proximal and middle ureteral strictures. Distal strictures are treated with ureteroneocystostomy and are often combined with a Boari and/or Psoas Hitch flap. Particularly, the treatment of long-segment strictures in the proximal and middle ureter remain a surgical challenge. The use of bowel interposition is an established treatment option for this, offering good functional results but also potential associated complications. Robot-assisted surgery is increasingly becoming a minimally invasive treatment alternative to reduce hospital stays and optimize postoperative recovery. However, open surgical ureteral reconstruction remains an established procedure, especially after multiple previous abdominal operations.
U2 - 10.1007/s00120-023-02232-z
DO - 10.1007/s00120-023-02232-z
M3 - SCORING: Review
C2 - 37989869
VL - 63
SP - 25
EP - 33
JO - UROLOGE
JF - UROLOGE
SN - 0340-2592
IS - 1
ER -
