Please use this identifier to cite or link to this item: http://repositorio.unifesp.br/handle/11600/38440
Title: Fetoscopic single-layer repair of open spina bifida using a cellulose patch: preliminary clinical experience
Authors: Pedreira, Denise A. L.
Zanon, Nelci [UNIFESP]
Sa, Renato A. M. de
Acacio, Gregorio L.
Ogeda, Edilson
Belem, Teresa M. L. O. U.
Chmait, Ramen H.
Kontopoulos, Eftichia
Quintero, Ruben A.
Universidade de São Paulo (USP)
Samaritano Hosp
Universidade Federal de São Paulo (UNIFESP)
Universidade Federal Fluminense (UFF)
Univ Taubate
Univ So Calif
Jackson Mem Hosp
Keywords: Cellulose
fetal therapy
fetoscopy
meningomyelocele
myelomeningocele
spina bifida
Issue Date: 1-Nov-2014
Publisher: Informa Healthcare
Citation: Journal of Maternal-fetal & Neonatal Medicine. London: Informa Healthcare, v. 27, n. 16, p. 1613-1619, 2014.
Abstract: Objective: To report our preliminary clinical experience in the antenatal correction of open spina bifida (OSB) using a fetoscopic approach and a simplified closure technique.Methods: Four fetuses with lumbar-sacral defects were operated in utero from 25 to 27 weeks. Surgeries were performed percutaneously under general anesthesia using three trocars and partial carbon dioxide insufflation. After dissection of the neural placode, the surrounding skin was closed over a cellulose patch using a single continuous stitch.Results: Surgical closure was successful in three of the four cases. All successful cases showed improvement of the hindbrain herniation and no neonatal neurosurgical repair was required in two cases. Delivery occurred between 31 and 33 weeks, and no fetal or neonatal deaths occurred. Ventriculoperitoneal shunting was not needed in two out of the 3 successful cases.Conclusions: Our preliminary experience suggests that definitive fetoscopic repair of OSB is feasible using our innovative surgical technique. A phase I trial for the fetoscopic correction of OSB with this technique is currently being conducted.
URI: http://repositorio.unifesp.br/handle/11600/38440
ISSN: 1476-7058
Other Identifiers: http://dx.doi.org/10.3109/14767058.2013.871701
Appears in Collections:Em verificação - Geral

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