Fetoscopic endoluminal tracheal occlusion and reestablishment of fetal airways for congenital diaphragmatic hernia

被引：68

作者：

Van der Veeken, Lennart ^{[1
,2
]}

Russo, Francesca Maria ^{[1
,2
]}

De Catte, Luc ^{[1
,2
]}

Gratacos, Eduard ^{[3
,4
,5
,6
]}

Benachi, Alexandra ^{[3
,7
,18
]}

Ville, Yves ^{[3
,8
,9
]}

Nicolaides, Kypros ^{[3
]}

Berg, Christoph ^{[3
,10
,11
]}

Gardener, Glenn ^{[3
,12
]}

Persico, Nicola ^{[3
,13
]}

Bagolan, Pietro ^{[3
,14
,18
]}

Ryan, Greg ^{[3
,15
]}

Belfort, Michael A. ^{[3
,16
,17
]}

Deprest, Jan ^{[1
,2
,3
,18
]}

机构：

[1] Katholieke Univ Leuven, Acad Dept Dev & Regenerat Woman & Child Biomed Sc, Herestr 49, B-3000 Leuven, Belgium

[2] Katholieke Univ Leuven, Clin Dept Obstet & Gynaecol, Herestr 49, B-3000 Leuven, Belgium

[3] TOTAL Tracheal Occlus Accelerate Lung Growth Tria, Leuven, Belgium

[4] Univ Barcelona, IDIBAPS, Hosp Clin, BCNatal Barcelona Ctr MaternaleFetal & Neonatal M, Barcelona, Spain

[5] Univ Barcelona, IDIBAPS, Hosp St Joan de Deu, Barcelona, Spain

[6] Ctr Biomed Res Rare Dis CIBER ER, Barcelona, Spain

[7] Univ Paris Sud, Hop Antoine Beclere, Dept Obstet Gynaecol & Reprod Med, Clamart, France

[8] Univ Paris 05, Necker Enfants Malad Hosp, Obstet & Fetal Med Dept, Fetal Med Unit,Sorbonne Paris Cite, Paris, France

[9] Kings Coll Hosp London, Harris Birthright Ctr, London, England

[10] Univ Bonn, Dept Obstet & Prenatal Med, Div Fetal Surg, Bonn, Germany

[11] Univ Cologne, Dept Obstet & Gynecol, Cologne, Germany

[12] Mater Res UQ, Mater Hlth Serv, Brisbane, Qld, Australia

[13] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Dept Obstet & Gynecol L Mangiagalli, Milan, Italy

[14] IRCCS, Bambino Gesu Childrens Hosp, Dept Med & Surg Neonatol, Neonatal Surg Unit, Piazza S Onofrio 4, I-00165 Rome, Italy

[15] Univ Toronto, Mt Sinai Hosp, Fetal Med Unit, Toronto, ON, Canada

[16] Baylor Coll Med, Dept Obstet & Gynecol, Houston, TX 77030 USA

[17] Texas Childrens Fetal Ctr, Houston, TX USA

[18] European Reference Network Rare & Inherited Conge, Rotterdam, Netherlands

来源：

GYNECOLOGICAL SURGERY | 2018年 / 15卷

基金：

英国工程与自然科学研究理事会; 英国惠康基金;

关键词：

FETO; Fetal endoluminal tracheal occlusion; CDH; Congenital diaphragmatic hernia; Fetal surgery; Fetoscopy;

D O I：

10.1186/s10397-018-1041-9

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: Congenital diaphragmatic hernia (CDH) is a congenital anomaly with high mortality and morbidity mainly due to pulmonary hypoplasia and hypertension. Temporary fetal tracheal occlusion to promote prenatal lung growth may improve survival. Entrapment of lung fluid stretches the airways, leading to lung growth. Methods: Fetal endoluminal tracheal occlusion (FETO) is performed by percutaneous sono-endoscopic insertion of a balloon developed for interventional radiology. Reversal of the occlusion to induce lung maturation can be performed by fetoscopy, transabdominal puncture, tracheoscopy, or by postnatal removal if all else fails. Results: FETO and balloon removal have been shown safe in experienced hands. This paper deals with the technical aspects of balloon insertion and removal. While FETO is invasive, it has minimal maternal risks yet can cause preterm birth potentially offsetting its beneficial effects. Conclusion: For left-sided severe and moderate CDH, the procedure is considered investigational and is currently being evaluated in a global randomized clinical trial (https://www.totaltrial.eu/). The procedure can be clinically offered to fetuses with severe right-sided CDH.

引用

页数：9

共 27 条

[1] Fetal Tracheal Occlusion for Severe Pulmonary Hypoplasia in Isolated Congenital Diaphragmatic Hernia A Systematic Review and Meta-analysis of Survival [J].