Navegando por Palavras-chave "spina bifida"

Agora exibindo 1 - 3 de 3
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Fetoscopic single-layer repair of open spina bifida using a cellulose patch: preliminary clinical experience
    (Informa Healthcare, 2014-11-01) 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
    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.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Histological evidence of reparative activity in chorioamniotic membrane following open fetal surgery for myelomeningocele
    (Spandidos Publ Ltd, 2017) Carvalho, Natalia S. [UNIFESP]; Moron, Antonio F. [UNIFESP]; Menon, Ramkumar; Cavalheiro, Sergio [UNIFESP]; Barbosa, Mauricio M. [UNIFESP]; Milani, Herbene J. [UNIFESP]; Ishigai, Marcia M. [UNIFESP]
    An increased understanding of the reparative process in fetal membrane following surgical techniques may be helpful to decrease the risks to mother and fetus and avoid adverse pregnancy outcomes. The present study discusses histological evaluation of the fetal membrane following open fetal surgery. Chorioamniotic membranes (n=10) were obtained following birth from pregnancies that underwent open fetal surgery for myelomeningocele. The collagen distribution was quantified using picrosirius-polarization method comparing the suture site with non-suture site. The differences between the collagen fiber percentages at the two sites was evaluated by the paired t-test with P<0.05. The mean gestational age of fetal surgery was 26.09 +/- 0.3 and 33.81 +/- 0.82 weeks at birth. The picrosirius red sign was more intense at the suture site, primarily associated with collagen type 1. Collagen observed in the surgical area was significantly increased (13.22 +/- 2.84%) compared with the non-surgical area (6.16 +/- 1.09%
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Procedure-related complications of open vs endoscopic fetal surgery for treatment of spina bifida in an era of intrauterine myelomeningocele repair: systematic review and meta-analysis
    (Wiley, 2016) Araujo Junior, E. [UNIFESP]; Eggink, A. J.; Van den Dobbelsteen, J.; Martins, W. P.; Oepkes, D.
    Objective To assess and compare the rate of procedure-related complications after intrauterine treatment of spina bifida by endoscopic surgery and by open fetal surgery. Methods Systematic literature searches in PubMed and SCOPUS databases were performed on 20 September 2015 to identify randomized controlled trials and observational studies on treatment of human spina bifida by endoscopic or open fetal surgery techniques. Only studies with >= 10 cases that were published in or after 2000 were included in the meta-analysis in order to reduce the risk of bias. Primary outcomes (complete dehiscence, focal dehiscence and/or markedly thin hysterotomy scar