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经单一套管针行经皮胎儿镜激光减压治疗先天性高气道梗阻综合征(CHAOS)喉闭锁——当前技术限制及未来干预的潜在解决方案

Percutaneous fetoscopic laser decompression of congenital high airway obstruction syndrome (CHAOS) from laryngeal atresia via a single trocar--current technical constraints and potential solutions for future interventions.

作者信息

Kohl Thomas, Van de Vondel Patricia, Stressig Rüdiger, Wartenberg Hans C, Heep Axel, Keiner Sabine, Müller Andreas, Franz Axel, Fröhlich Susanne, Willinek Winfried, Gembruch Ulrich

机构信息

Department of Obstetrics and Prenatal Medicine, German Center for Fetal Surgery and Minimally-Invasive Therapy, Bonn, Germany.

出版信息

Fetal Diagn Ther. 2009;25(1):67-71. doi: 10.1159/000200017. Epub 2009 Feb 6.

DOI:10.1159/000200017
PMID:19202341
Abstract

OBJECTIVE

To alleviate congenital high airway obstruction syndrome (CHAOS) from laryngeal atresia by percutaneous minimally-invasive fetoscopic tracheal decompression using laser.

METHODS

The procedure was performed via one trocar under general maternofetal anesthesia in a human fetus with CHAOS from laryngeal atresia at 21+6 weeks of gestation.

RESULTS

Normalization of the lung-heart size relationship was observed within days after the procedure. The fetus was delivered by ex utero intrapartum treatment (EXIT) in order to perform a tracheotomy at 31+1 weeks of gestation and survived hospital treatment to discharge.

CONCLUSIONS

Percutaneous minimally-invasive fetoscopic decompression of the fetal trachea via a single trocar is feasible in human fetuses with CHAOS from laryngeal atresia.

摘要

目的

通过使用激光经皮微创胎儿镜气管减压术缓解先天性高气道梗阻综合征(CHAOS)所致的喉闭锁。

方法

在孕21 + 6周患有因喉闭锁导致CHAOS的人类胎儿中,在母婴全身麻醉下经一个套管针进行该手术。

结果

术后数天内观察到肺心大小关系恢复正常。为了在孕31 + 1周时进行气管切开术,胎儿通过产时宫外治疗(EXIT)分娩,并在住院治疗后存活出院。

结论

对于因喉闭锁导致CHAOS的人类胎儿,经单个套管针进行经皮微创胎儿镜胎儿气管减压术是可行的。

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