Surgery of the Ureter - Küss, R.; Chatelain, C.
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There has been great progress in ureteral surgery in the last twenty years. The predominant indication is still calculous obstruction but reparative and plastic surgery of the ureter for congenital and acquired lesions are among the most interesting advances in modern urology. The essential goal of this surgery is to ensure free flow of the urine from the kidney to the bladder and so to preserve or improve kidney function which is always affected or threatened by any defect in the excretory pathway. The ideal is to re-establish a closed circuit flow from kidney to bladder by repair or…mehr

Produktbeschreibung
There has been great progress in ureteral surgery in the last twenty years. The predominant indication is still calculous obstruction but reparative and plastic surgery of the ureter for congenital and acquired lesions are among the most interesting advances in modern urology. The essential goal of this surgery is to ensure free flow of the urine from the kidney to the bladder and so to preserve or improve kidney function which is always affected or threatened by any defect in the excretory pathway. The ideal is to re-establish a closed circuit flow from kidney to bladder by repair or substitution of the ureteral conduit so as to avoid as far as possible the dis abilities that result from diversion of the urine to the skin surface or to the intestine. This objective can now be achieved in the treatment of most of the diseases of the ureter when the relevant kidney is sufficiently healthy to merit conserva tion. The techniques used are not necessarily new but the advent of antibiotics has made it possible to avoid or reduce the risks of infection, pyelonephritis, or pyonephrosis that so often complicated such surgery in earlier times. Progress in the investigation of renal function and of the excretory tract has brought a better understanding of the physio-pathology of the urinary apparatus and more accurate judgement of the results of reparative surgery.
  • Produktdetails
  • Encyclopedia of Urology Vol.13/3
  • Verlag: Springer, Berlin
  • Softcover reprint of the original 1st ed. 1975
  • Seitenzahl: 356
  • Erscheinungstermin: 27. Dezember 2011
  • Englisch
  • Abmessung: 244mm x 170mm x 19mm
  • Gewicht: 614g
  • ISBN-13: 9783642660818
  • ISBN-10: 3642660819
  • Artikelnr.: 36122194
Inhaltsangabe
General Considerations.- I. The Surgical Approach to the Ureter.- 1. Exposure of the Lumbar Ureter.- A. Lumbar, Extraperitoneal Approach.- B. "Limited", Muscle-Splitting Approach to the Lumbar Ureter.- C. Posterior Approach.- 2. Exposure of the Iliac Ureter.- a) Extraperitoneal Iliac Approach.- b) Modifications.- 3. Exposure of the Pelvic Ureter.- A. Lateral Extraperitoneal Approach.- B. Midline Extraperitoneal Approach.- 4. Exposure of the Terminal Ureter.- A. Lateral, Paravesical Approach.- B. Transvesical Approach.- C. Combined Approach (Intra- and Extra-Vesical).- D. Vaginal Approach.- 5. Transperitoneal Exposure of the Ureter.- A. Segmental Exposure.- a) The Lumbar Ureter.- b) The Iliac Ureter.- c) The Pelvic Ureter.- B. Exposure of Entire Ureter.- II. Ureterolysis.- A. Simple Ureterolysis.- B. Ureterolysis with Intraperitoneal Transposition of the Ureters.- a) Indications.- b) Technique.- c) Modifications.- d) Results and Limitations of the Operation.- III. Ureterotomy.- 1. Ureterolithotomy.- A. Iliac Ureterolithotomy.- a) Finding and Controlling the Stone.- b) Ureteral Incision and Removal of the Stone.- c) Suture of the Ureter.- d) Drainage.- B. Modifications.- a) The Position of the Stone.- b) Ureteral Lesions.- c) Repeated Ureterotomy.- C. Post-Operative Course - Complications - Results.- 2. Ureterotomy for Stenosis.- 3. Extramucosal Ureterotomy.- IV. Ureteral Anastomosis.- 1. Uretero-Ureteral Anastomosis.- A. End-to-End Anastomosis.- a) Operative Technique.- B. End-to-Side Anastomosis.- 2. Uretero-Pelvic and Uretero-Calyceal Anastomosis.- A. Uretero-Pelvic Anastomosis.- a) Uretero-Pelvic Anastomosis after Resection of Pelvi-Ureteral Junction.- b) Uretero-Pelvic Anastomosis without Resection (Side-to-Side).- B. Uretero-Calyceal Anastomosis.- a) Operative Technique.- b) Indications - Results.- 3. Uretero-Vesical Anastomosis: Ureteroneocystostomy.- A. Direct Uretero-Vesical Implantation.- a) Uretero-Vesical Implantation by Combined Transvesical and Extra-vesical Approach.- b) Modifications.- c) Indications and Results.- B. Side-to-Side Uretero-Vesical Anastomosis.- a) Operative Technique.- b) Indications and Results.- V. Ureterectomy.- 1. Segmental Ureterectomy.- A. Segmental Resection of the Lumbar Ureter.- a) Mobilization of the Kidney.- b) Renal Autotransplantation.- B. Segmental Resection of Iliac and Pelvic Ureter.- C. Resection of the Terminal Ureter.- a) Resection of the Terminal Ureter above the Ureteral Orifice.- b) Transvesical Resection of Terminal Ureter (Including the Ureteral Orifice).- D. Multiple Resections of the Ureter.- 2. Total Ureterectomy.- a) Total Ureterectomy with Preservation of the Kidney.- b) Total Nephro-Ureterectomy.- c) Ureterectomy of Residual Ureter (after Previous Nephrectomy).- VI. Replacement Ureteroplasty.- a) Inert Ureteral Prostheses.- b) Regeneration of the Ureter.- c) Preserved Human Tissues.- d) Pedicled Grafts.- 1. Ureteroplasty with a Tubed Bladder Flap.- A. The Boari-Küss Operation.- a) Surgical Approach.- b) Size of the Bladder Flap.- c) Tubing the Flap and End-to-End Anastomosis of the Tube to the Ureter.- d) Closure.- B. Alternative Techniques.- a) Anastomosis by Intubation.- b) Bilateral Ureterocystoplasty.- C. Postoperative Course and Complications.- D. Indications and Long Term Results.- a) Long Term Results.- 2. Pyelo-Ureteroplasty with a Tubed Flap from Renal Pelvis.- a) Operative Technique.- b) Results.- 3. Uretero-Ureterostomy.- a) Homolateral Uretero-Ureterostomy.- b) Crossed Uretero-Ureterostomy.- Technique.- c) Discussion and Results.- 4. Entero-Ureteroplasty.- A. Surgical Technique.- a) Total Left Ileo-Ureteroplasty.- b) Total Right Ileo-Ureteroplasty.- c) Partial Ileo-Ureteroplasty.- d) Left Colo-Ureteroplasty.- e) Bilateral Entero-Ureteroplasty.- f) Ureteroplasty Utilising the Ileo-Caeco-Colic Segment.- g) Entero-Ureterocystoplasty.- B. Postoperative Course - Complications - Results.- a) Early Complications.- b) Operative Mortality.- c) The Long Term Resu