Fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia: a narrative review of the history, current practice, and future directions
| Autor: | Jan Deprest, Erin E. Perrone |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment IN-UTERO Balloon Pediatrics law.invention PULMONARY-HYPERTENSION 03 medical and health sciences congenital diaphragmatic hernia (CDH) 0302 clinical medicine Randomized controlled trial law FETUSES 030225 pediatrics Fetal intervention Occlusion medicine MANAGEMENT PRENATAL-DIAGNOSIS PREDICTORS Fetal endoscopic tracheal occlusion (FETO) HYPOPLASTIC LUNG 030219 obstetrics & reproductive medicine Science & Technology business.industry Fetal surgery Congenital diaphragmatic hernia medicine.disease Pulmonary hypertension Review Article on Fetal Surgery Surgery ENDOTRACHEAL OCCLUSION Systematic review Pediatrics Perinatology and Child Health embryonic structures SURVIVAL fetal intervention TO-HEAD RATIO business Life Sciences & Biomedicine |
| Zdroj: | Transl Pediatr |
| Popis: | Fetal intervention for fetuses with congenital diaphragmatic hernia (CDH) has been investigated for over 30 years and is summarized in this manuscript. The review begins with a discussion of the history of fetal intervention for this severe congenital anomaly beginning with open fetal surgery with repair of the anatomical defect, shifting towards tracheal occlusion via open surgery techniques, and finally fetoscopic endoluminal balloon tracheal occlusion using a percutaneous approach. The current technique of fetal endoscopic tracheal occlusion (FETO) is described in detail with steps of the procedure and complementary figures. The main outcomes of single-institutional studies and multiple systematic reviews are examined and discussed. Despite these studies, the fetal community agrees that FETO remains investigational at this time as there is insufficient evidence to recommend it as the standard of care for CDH. A randomized controlled trial, The Tracheal Occlusion to Accelerate Lung Growth (TOTAL) trial, has been designed to attempt to answer this question in an elaborate, international, multi-institutional study and is described in the text. Finally, future directions of fetal intervention for antenatally diagnosed CDH are discussed, including options for non-isolated CDH, the Smart-TO balloon for nonoperative reversal of occlusion, and transplacental sildenafil for treatment of pulmonary hypertension prior to birth. ispartof: TRANSLATIONAL PEDIATRICS vol:10 issue:5 pages:1448-1460 ispartof: location:China status: published |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|