New and/or improved aspects of fetal surgery |
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Authors: | François I Luks |
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Institution: | Division of Pediatric Surgery, Alpert Medical School of Brown University, Providence, RI, USA |
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Abstract: | Open fetal surgery through a wide hysterotomy is no longer a real option for prenatal intervention, but a minimally invasive approach has emerged as treatment for a small number of indications. Endoscopic ablation of placental vessels is the preferred treatment for severe twin-to-twin transfusion syndrome and it may be the only chance to salvage the most severe forms of congenital diaphragmatic hernia. Several other indications are currently under review and may become justified in the future, provided that diagnostic accuracy and patient selection become more accurate. Before invasive fetal intervention becomes widely accepted, however, we need to better define outcome. It is no longer acceptable to express results in terms of survival at birth. Survival at discharge and long-term morbidity must be considered as well. Copyright © 2011 John Wiley & Sons, Ltd. |
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Keywords: | fetal therapy fetal ultrasound fetal imaging fetal and placental pathology congenital diaphragmatic hernia twin-to-twin transfusion syndrome endoscopic surgery |
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