FETAL SURGERY FOR CONGENITAL HYDRONEPHROSIS
FETAL SURGERY FOR CONGENITAL HYDRONEPHROSIS
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DOI：
10.1056/nejm198203113061006
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发表时间：
1982-01-01
影响因子：
158.5
通讯作者：
JONSEN, AR
中科院分区：
文献类型：
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作者：
HARRISON, MR;GOLBUS, MS;JONSEN, AR
虽然许多胎儿解剖异常现在可以通过超声诊断，但只有少数会影响产前处理。1对于因尿路梗阻而继发的严重双侧肾积水的胎儿，应尽快进行尿路减压，以减少对发育中的肾脏和肺的持续损害。2然而，灵长类动物(包括人类)的胎儿手术已被证明是困难的，因为妊娠子宫极其敏感，因此容易早产和流产。最近，在非人类灵长类动物的胎儿外科手术中，麻醉、手术和宫缩技术的成功发展使我们能够进行双侧输尿管吻合术。
ALTHOUGH many fetal anatomic abnormalities can now be diagnosed by sonography, only a few will affect prenatal management.1In the fetus with severe bilateral hydronephrosis secondary to urethral obstruction, the urinary tract should be decompressed as soon as possible in order to reduce the ongoing damage to the developing kidneys and lungs.2However, fetal surgery in primates (including human beings) has proved difficult because the gravid uterus is exquisitely sensitive and thus liable to preterm labor and abortion. The recent development of successful anesthetic, surgical, and tocolytic techniques for fetal surgery in nonhuman primates3allowed us to perform bilateral ureterostomies . . .