Exploring new perspectives on congenital diaphragmatic hernia: A comprehensive review

Renik-Jankowska, Weronika; Buczyńska, Angelika; Sidorkiewicz, Iwona; Kosiński, Przemysław; Zbucka-Krętowska, Monika

doi:10.1016/j.bbadis.2024.167105

Cited by 1 publication

(1 citation statement)

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“…Further studies are necessary to evaluate the long-term outcomes regarding the mortality, and especially the morbidity, of those infants who have undergone FETO [ 35 ] to guide the long-term impact factors on counselling and the ethical considerations [ 36 , 37 ]. Moreover, novel approaches may be developed to prevent FETO-related complications and improve neonatal management [ 38 , 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Fetoscopic Tracheal Occlusion for Isolated Severe Left Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

Provinciatto,

Barbalho,

Araujo Júnior

et al. 2024

JCM

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Background: We aimed to conduct a systematic review and meta-analysis to evaluate the fetoscopic tracheal occlusion in patients with isolated severe and left-sided diaphragmatic hernia. Methods: Cochrane Library, Embase, and PubMed (Medline) databases were searched from inception to February 2024 with no filters or language restrictions. We included studies evaluating the outcomes of fetoscopic intervention compared to expectant management among patients with severe congenital diaphragmatic hernia exclusively on the left side. A random-effects pairwise meta-analysis was performed using RStudio version 4.3.1. Results: In this study, we included 540 patients from three randomized trials and five cohorts. We found an increased likelihood of neonatal survival associated with fetoscopic tracheal occlusion (Odds Ratio, 5.07; 95% Confidence Intervals, 1.91 to 13.44; p < 0.01) across general and subgroup analyses. Nevertheless, there were higher rates of preterm birth (OR, 5.62; 95% CI, 3.47–9.11; p < 0.01) and preterm premature rupture of membranes (OR, 7.13; 95% CI, 3.76–13.54; p < 0.01) in fetal endoscopic tracheal occlusion group compared to the expectant management. Conclusions: Our systematic review and meta-analysis demonstrated the benefit of fetoscopic tracheal occlusion in improving neonatal and six-month postnatal survival in fetuses with severe left-sided CDH. Further studies are still necessary to evaluate the efficacy of tracheal occlusion for isolated right-sided CDH, as well as the optimal timing to perform the intervention.

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