Fetoscopic Endotracheal Occlusion for Severe Isolated Diaphragmatic Hernia: Initial Experience from a Single Clinic in Brazil

被引:44
作者
Andrioli Peralta, Cleisson Fabio [1 ]
Sbragia, Lourenco [2 ]
Bennini, Joao Renato [1 ]
Assuncao Braga, Angelica de Fatima [3 ]
Rousselet, Monique Sampaio [3 ]
Machado Rosa, Izilda Rodrigues [4 ]
Barini, Ricardo [1 ]
机构
[1] Univ Estadual Campinas, Sch Med, Ctr Integral Assistance Womens Hlth, Dept Obstet & Gynecol, BR-13083970 Campinas, SP, Brazil
[2] Univ Estadual Campinas, Sch Med, Ctr Integral Assistance Womens Hlth, Dept Surg, BR-13083970 Campinas, SP, Brazil
[3] Univ Estadual Campinas, Sch Med, Ctr Integral Assistance Womens Hlth, Anesthesiol Sect, BR-13083970 Campinas, SP, Brazil
[4] Univ Estadual Campinas, Sch Med, Ctr Integral Assistance Womens Hlth, Div Neonatol, BR-13083970 Campinas, SP, Brazil
关键词
Congenital diaphragmatic hernia; Diaphragmatic hernia; Endotracheal occlusion; Fetoscopy; Herniation; Lung expansion; Tracheal occlusion; TO-HEAD RATIO; TRACHEAL OCCLUSION; LUNG AREA; FETUSES; SURVIVAL; PREDICTION; LIVER;
D O I
10.1159/000314617
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To report on the initial experience in a single Brazilian university clinic of the use of fetoscopic endotracheal occlusion (FETO) to treat severe isolated congenital diaphragmatic hernia (CDH). Methods: The inclusion criteria for FETO for this prospective study were isolated CDH and intrathoracic herniation of the liver, as well as the lung area to head circumference ratio (LHR)<1.0.The main variables evaluated were LHR and observed to expected (o/e) LHR before and after FETO, gestational age (GA) at FETO, reversal of tracheal occlusion (TO), and birth and discharge of a living child from the hospital. Results: Among 8 isolated left-sided CDH cases with normal karyotypes, the median LHR and o/e LHR before FETO were 0.7 (range: 0.6-0.9) and 0.27 (range: 0.22-0.32), respectively. The median LHR and o/e LHR after FETO were 1.2 (range: 0.9-1.8) and 0.45 (0.31-0.67), respectively. The median GA at FETO, reversal of TO and birth were 26.8 (range: 26-29), 32.5 (range: 31.0-34.0) and 37 weeks (range: 35-37), respectively. Neonatal survival at the time of hospital discharge was 50% (4/8). Conclusion: FETO is feasible at our institution and may help to improve postnatal survival of children with severe CDH in developing countries. Copyright (C) 2011 S. Karger AG, Basel
引用
收藏
页码:71 / 77
页数:7
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