Fetoscopy for meningomyelocele repair: past, present and future
Fetoscopy for meningomyelocele repair: past, present and future
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DOI：
10.1590/s1679-45082015rw3032
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发表时间：
2015-06-01
期刊：
影响因子：
--
通讯作者：
Pedreira, Denise Araujo Lapa
中科院分区：
文献类型：
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作者：
Bevilacqua, Nicole Silva;Pedreira, Denise Araujo Lapa
脊膜脊髓膨出是一种发病率较高的畸形，其主要合并症之一是Arnold-Chiari畸形II型。子宫内修复这一缺陷已被研究，以减少妊娠期间进行性脊髓损伤。本综述的目的是描述胎儿手术修复脊髓脊膜膨出的进展。检索PubMed数据库，包括过去10年发表的文章。选择了27篇文章，16项实验研究和11项人体研究。最近的一项研究表明，胎儿矫正导致神经和精神发育的预后更好，但开放手术，这已被广泛使用，有相当大的母亲风险。在动物和人类模型中的研究表明，内窥镜方法是可行的，并导致产妇发病率较低。两种内窥镜技术目前正在评估中，一种在德国，另一种在巴西，我们相信，内窥镜方法将是未来的技术，产前修复这一缺陷。
Meningomyelocele is a malformation with high prevalence, and one of its main comorbidities is Arnold-Chiari malformation type II. The intrauterine repair of this defect has been studied to reduce the progressive spinal cord damage during gestation. The purpose of the present review was to describe the evolution of fetal surgery for meningomyelocele repair. Searches on PubMed database were conducted including articles published in the last 10 years. Twenty-seven articles were selected, 16 experimental studies and 11 studies in humans. A recent study demonstrated that the fetal correction results in better prognosis of neurological and psychomotor development, but open surgery, which has being used widely, has considerable maternal risks. Studies in animal and human models show that the endoscopic approach is feasible and leads to lower maternal morbidity rates. Two endoscopic techniques are currently under assessment-one in Germany and another in Brazil, and we believe that the endoscopic approach will be the future technique for prenatal repair of this defect.