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  • S. Karger AG  (2)
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  • S. Karger AG  (2)
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  • 1
    Online Resource
    Online Resource
    S. Karger AG ; 2020
    In:  Fetal Diagnosis and Therapy Vol. 47, No. 2 ( 2020), p. 138-144
    In: Fetal Diagnosis and Therapy, S. Karger AG, Vol. 47, No. 2 ( 2020), p. 138-144
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To evaluate the efficiency of percutaneous intratumor laser ablation for fetal solid sacrococcygeal teratoma (SCT). 〈 b 〉 〈 i 〉 Subjects and Methods: 〈 /i 〉 〈 /b 〉 We carried out percutaneous ultrasound-guided intratumor laser ablation through a 17-gauge needle using an output of 40 W in 7 fetuses with large solid SCT and reviewed the literature for minimally invasive therapy for this condition. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Laser ablation was carried out at a median gestational age of 20 (range 19–23) weeks, and in all cases there was elimination of obvious vascularization within the tumor and improvement in cardiac function. Three (43%) babies survived and had surgical excision of the tumor within 2 days of birth, 3 liveborn babies died within 5 days of birth and before surgery, and 1 fetus died within 2 weeks after the procedure. In previous series of various percutaneous interventions for predominantly solid SCT the survival rate was 33% (2/6) (95% CI 9.7–70%) for endoscopic laser to superficial vessels, 57% (4/7) (95% CI 25–84%) for intratumor laser, 67% (8/12) (95% CI 39–86%) for intratumor radiofrequency ablation, and 20% (1/5) (95% CI 3.6–62%) for intratumor injection of alcohol. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 In solid SCT, the reported survival from intratumor laser or radiofrequency ablation is about 50%, but survival does not mean success, and it remains uncertain whether such interventions are beneficial or not because the number of fetuses is small and there were no controls that were managed expectantly.
    Type of Medium: Online Resource
    ISSN: 1015-3837 , 1421-9964
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1482292-1
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  • 2
    In: Fetal Diagnosis and Therapy, S. Karger AG, Vol. 41, No. 3 ( 2017), p. 179-183
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To evaluate the efficiency of thoracoamniotic shunts for drainage of macrocystic-type congenital cystic adenomatoid malformation (CCAM). 〈 b 〉 〈 i 〉 Subjects and Methods: 〈 /i 〉 〈 /b 〉 This was a retrospective study of 12 fetuses with a large thoracic cyst treated with thoracoamniotic shunting between 2004 and 2014 in a tertiary fetal therapy center. Medline was searched to identify cases of CCAM treated with thoracoamniotic shunting. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In all cases the thoracic cyst was associated with major mediastinal shift, the CCAM volume ratio (CVR) was 〉 1.6, and in eight cases there was associated hydrops. Shunt insertion was successfully carried out in all cases at a median gestational age of 24 weeks (range 18-34). In 10 cases there was live birth at a median age of 38 weeks (range 35-41), but in two hydropic fetuses there was intrauterine death. A literature search identified a total of 98 fetuses with CCAM treated with thoracoamniotic shunting between 1987 and 2016. In the combined data from the previous and the current study, the survival rate was 77% (53 of 69) for hydropic and 90% (37 of 41) for nonhydropic fetuses. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The role of thoracoamniotic shunting in macrocystic lung lesions associated with hydrops is well accepted. Intrauterine intervention is also likely to be beneficial in the subgroup of nonhydropic fetuses with a CVR 〉 1.6.
    Type of Medium: Online Resource
    ISSN: 1015-3837 , 1421-9964
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482292-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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