Outcome after fetoscopic selective laser ablation of placental anastomoses vs equatorial laser dichorionization for the treatment of twin-to-twin transfusion syndrome

Baschat, Ahmet; Barber, James; Pedersen, Nicole; Turan, Özhan; Harman, Chris

doi:10.1016/j.ajog.2013.05.034

Cited by 73 publications

(122 citation statements)

References 18 publications

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“…Early diagnosis, however, may allow intervention with fetoscopic laser ablation, which significantly improves the prognosis. Laser treatment in these pregnancies results in 60-70% double survival and 80-90% of women being able to take home at least one baby (Baschat et al, 2013;Roberts et al, 2014).…”

mentioning

confidence: 99%

Evolution of Stage 1 Twin-to-Twin Transfusion Syndrome (TTTS): Systematic Review and Meta-Analysis

et al. 2016

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Objectives: The natural history of stage 1 Twin-to-twin transfusion syndrome (TTTS) remains unclear and its optimal management is yet to be established. The main aims of this meta-analysis were to quantify the incidence of progression in stage 1 TTTS and to ascertain survival in these pregnancies. Methods: MEDLINE, EMBASE, and The Cochrane Library were searched. Reference lists within each article were hand-searched for additional reports. The outcomes included incidence of progression and survival in stage 1 TTTS. Randomized controlled trials, cohort and case-control studies were included. Case reports, studies including three or fewer cases of stage 1 TTTS, and editorials were excluded. Proportion metaanalysis was used for analysis (Registration number: CRD42016036190). Results: The search yielded 3,085 citations; 18 studies were included in the review (172 pregnancies to assess progression and 433 pregnancies to assess the survival

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mentioning

confidence: 99%

Evolution of Stage 1 Twin-to-Twin Transfusion Syndrome (TTTS): Systematic Review and Meta-Analysis

et al. 2016

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“…The surgeons who operated on the cases in our study were experienced and were not new to laser surgery 6 . Thus, we feel that the improvement in dual survival that we, and others 7 , have shown following adoption of the Solomon technique is most probably due to the benefits of the technique itself, and not due to increasing experience of the operators. In fact, the results of one of our trainees, who learned to perform laser therapy using only the Solomon technique, show dual survival of 70% (14/20) for his first 20 cases (pers.…”

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confidence: 99%

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Ruano

Rodó

Peiró

et al. 2014

Ultrasound in Obstet & Gyne

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“…Mais recentemente, foi proposta a técnica de dicorionização equatorial de Solomon, cujo objetivo é causar uma separação completa dos territórios da placenta monocoriônica 22 . É realizada através da aplicação do laser de forma a conectar os vasos anteriormente coagulados, criando uma linha virtual que corresponde ao equador vascular.…”

Section: Principais Procedimentos Cirúrgicos Fetais I) Fotocoagulaçãounclassified

Cirurgia fetal no contexto atual

Rocha

Filho

Bunduki

et al. 2018

Rev. Med. (São Paulo)

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RESUMO:A cirurgia fetal é, hoje, uma realidade em grandes centros especializados na área da medicina fetal. Surgiu por volta da década de 1960, inicialmente atrelada à necessidade de melhor conhecer e entender as patologias fetais, e teve desenvolvimento exponencial impulsionado pelo aprimoramento das técnicas diagnósticas pré-natais. Foi aos poucos se consolidando e tornando-se o tratamento de escolha para algumas patologias específicas, mudando definitivamente o curso dessas doenças. Nesse estudo, encontra-se um breve histórico das cirurgias fetais mais comumente realizadas em todo o mundo, como elas surgiram e como foram evoluindo com o passar do tempo, os principais estudos que as validaram e a técnica cirúrgica mais amplamente utilizada em cada caso. Entre as principais cirurgias, são citadas a fotocoagulação a laser de anastomoses placentárias na síndrome de transfusão feto-fetal, a correção intrauterina a céu aberto da mielomeningocele fetal e a oclusão endotraqueal fetal por balão nos casos de hérnia diafragmática congênita. Também são abordados cirurgias e procedimentos cujos benefícios são menos evidentes e os resultados ainda um tanto controversos, como as intervenções urinárias nos casos de obstrução ao trato urinário inferior, procedimentos cardíacos em casos de estenose aórtica crítica, derivações tóracoamnióticas para tratamento de derrames pleurais compressivos, além de ressecções intrauterinas de teratomas sacrococcígeos e de massas pulmonares. Também é feita uma avaliação a respeito do futuro da cirurgia fetal.Descritores: Feto/cirurgia; Fetoscopia. ABSTRACT:Fetal surgery is now a reality in large centers that specialize in the field of fetal medicine. Fetal surgery emerged in the 1960s, primarily from the need to better identify and understand fetal pathologies, and its exponential development was driven by improvements in prenatal diagnostic techniques. Fetal surgery gradually became the main treatment for specific fetal pathologies, changing the course of these diseases. This study summarizes the history of the fetal surgeries that are most commonly performed worldwide, how they started and how they evolved over time, the main validation trials and the most widely used surgical technique in each case. The main surgeries include laser photocoagulation of placental anastomoses in twin-to-twin transfusion syndrome, in utero repair of fetal myelomeningocele and fetal endotracheal occlusion in cases of congenital diaphragmatic hernia. Other surgeries and procedures, whose benefits are less clear and whose results are still somewhat controversial, such as urinary interventions in cases of lower urinary tract obstruction, cardiac procedures in cases of critical aortic stenosis, thoracoamniotic shunts for the treatment of massive pleural effusions and intrauterine resection of sacrococcygeal teratomas and pulmonary masses, are also cited. The future of fetal surgery is also assessed.

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Outcome after fetoscopic selective laser ablation of placental anastomoses vs equatorial laser dichorionization for the treatment of twin-to-twin transfusion syndrome

Cited by 73 publications

References 18 publications

Evolution of Stage 1 Twin-to-Twin Transfusion Syndrome (TTTS): Systematic Review and Meta-Analysis

Evolution of Stage 1 Twin-to-Twin Transfusion Syndrome (TTTS): Systematic Review and Meta-Analysis

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Cirurgia fetal no contexto atual

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