Fetoscopic endoluminal tracheal occlusion and reestablishment of fetal airways for congenital diaphragmatic hernia
Articolo
Data di Pubblicazione:
2018
Citazione:
Fetoscopic endoluminal tracheal occlusion and reestablishment of fetal airways for congenital diaphragmatic hernia / L. Van der Veeken, F.M. Russo, L. De Catte, E. Gratacos, A. Benachi, Y. Ville, K. Nicolaides, C. Berg, G. Gardener, N. Persico, P. Bagolan, G. Ryan, M.A. Belfort, J. Deprest. - In: GYNECOLOGICAL SURGERY. - ISSN 1613-2076. - 15:1(2018), pp. 9.1-9.9. [10.1186/s10397-018-1041-9]
Abstract:
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.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
CDH; Congenital diaphragmatic hernia; Fetal endoluminal tracheal occlusion; Fetal surgery; FETO; Fetoscopy
Elenco autori:
L. Van der Veeken, F.M. Russo, L. De Catte, E. Gratacos, A. Benachi, Y. Ville, K. Nicolaides, C. Berg, G. Gardener, N. Persico, P. Bagolan, G. Ryan, M.A. Belfort, J. Deprest
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