Fetoscopic Open Neural Tube Defect Repair Development and Refinement of a Two-Port, Carbon Dioxide Insufflation Technique
Fetoscopic Open Neural Tube Defect Repair Development and Refinement of a Two-Port, Carbon Dioxide Insufflation Technique
复制标题
DOI：
10.1097/aog.0000000000001941
复制
发表时间：
2017-04-01
影响因子：
7.2
通讯作者：
Cass, Darrell L.
中科院分区：
文献类型：
--
作者：
Belfort, Michael A.;Whitehead, William E.;Cass, Darrell L.
目的：描述在外置、充满二氧化碳的子宫中进行脊柱裂修补术的双孔胎儿镜技术的发展，并报告两组患者的早期结果：前15例采用迭代技术治疗，后13例采用标准化技术。方法：这是一项回顾性队列研究（2014-2016）。所有患者均符合脊髓脊膜膨出治疗研究选择标准。在前15例患者中，术中方法是迭代的，然后标准化。比较产科、母体、胎儿和早期新生儿结局。适当时使用标准参数和非参数检验。结果：报告了28名患者的数据（22名仅内窥镜，4名混合，2名放弃），但仅分析了那些进行完整胎儿镜修复的患者（迭代技术[n=10]与标准化技术[n=12]相比）。胎儿手术时母亲的人口统计学资料和胎龄（中位数[范围]）（25.4 [22.9-25.9]与24.8 [24-25.6]周）相似，但迭代技术的分娩发生在35.9（26-39）周妊娠，而标准技术的分娩发生在39（35.9-40）周妊娠（P
OBJECTIVE: To describe development of a two-port fetoscopic technique for spina bifida repair in the exteriorized, carbon dioxide-filled uterus and report early results of two cohorts of patients: the first 15 treated with an iterative technique and the latter 13 with a standardized technique.METHODS: This was a retrospective cohort study (2014-2016). All patients met Management of Myelomeningocele Study selection criteria. The intraoperative approach was iterative in the first 15 patients and was then standardized. Obstetric, maternal, fetal, and early neonatal outcomes were compared. Standard parametric and nonparametric tests were used as appropriate.RESULTS: Data for 28 patients (22 endoscopic only, four hybrid, two abandoned) are reported, but only those with a complete fetoscopic repair were analyzed (iterative technique [n=10] compared with standardized technique [n=12]). Maternal demographics and gestational age (median [range]) at fetal surgery (25.4 [22.9-25.9] compared with 24.8 [24-25.6] weeks) were similar, but delivery occurred at 35.9 (26-39) weeks of gestation with the iterative technique compared with 39 (35.9-40) weeks of gestation with the standardized technique (P