Perspectivas em cirurgia fetal: abordagem sono-endoscópica

Pedreira, D. A. L.; Maria, Roberto dos Santos

doi:10.1590/s0102-86501999000300011

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“…De Lia et al 9 , proposed an open surgical approach aiming to coagulate the anastomotic vessel using laser, interrupting the transfusion among the twins. Ville et al 10 , report the first successful case treated with laser using a new less invasive percutaneos approach, starting the utilization of a so called sono-endoscopic technique 11 . The procedure consisted in introducing an optical device in the uterine cavity, guided by ultrasonography, towards the placental surface.…”

Section: Introductionmentioning

confidence: 99%

Laser for the treatment of twin to twin transfusion syndrome

et al. 2005

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Purpose:To report the initial experience in our country with a new technique for twin to twin transfusion syndrome (TTTS) treatment, using laser to coagulate the placental vessels responsible for the twin transfusion during gestation. Methods: Prospective study of eight cases diagnosed with TTTS evaluated in our service from january 2001 to june 2005. Through percutaneous introduction of a 2,0mm diameter fetoscope in the uterine cavity, placental surface vessels where directly visualized. Those identified as responsible for the transfusion were laser coagulated. The procedure combines ultrasonography and fetoscopy, in a so-called sonoendoscopic technique (FETENDO). Results: Among the eight pregnancies evaluated, five cases were submitted to the procedure (10 fetuses). All fetuses survived for at least five weeks after surgery. A total of eight fetuses were born alive and five survived the neonatal period. In a 18 months follow-up after birth, all five are still alive and well and their mean age is now 10,6 months. The total survival rate was 50% and in three pregnancies, at least one fetus survived. Conclusions: Laser fetoscopy is actually the "gold-standard" treatment of TTTS. Nevertheless is a sophisticated technique that depends of proper training. Our service is the first in our country to offer this therapeutic technique. Our success rate is comparable with the international literature.

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Section: Introductionmentioning

confidence: 99%