Department of Plastic Surgery, Wroclaw Medical University, Polanica-Zdroj, Poland.
Med Sci Monit. 2010 Nov;16(11):RA237-44.
Fetal surgery, also referred to as in utero, prenatal or intrauterine surgery, consists of treatment of congenital malformations during fetal period. The idea of treating malformations diagnosed in the course of intrauterine life dates back to 1963, when Lilly performed first blood transfusion in the fetus. Ever since then, it has been introduced as treatment option in series of lethal malformations. Efforts are being made to treat nonlethal malformations by means of fetal surgery.
MATERIAL/METHODS: A comprehensive search of the literature using MEDLINE and PubMed between 1925 and February 2009 was performed. Search terms for MEDLINE and PubMed were: fetal surgery, foetal surgery, in utero surgery, prenatal surgery, and in utero treatment. In addition, information was obtained at Web sites of International Medicine and Surgery Society and the University of California Fetal Treatment Centre.
Our attention focused on the overall view on fetal surgery history, its development and perspectives. Moreover, owing to the authors' interest in plastic surgery, some remarks on the role of intrauterine medicine and surgery in this branch of medicine were made.
In utero surgery may be regarded as an efficient tool of preventive medicine. It offers some advantages that no other branch of medicine may offer. However, its implementation is more troublesome than it used to be regarded as before. Therefore only selected cases may benefit from its advantages. Nevertheless, current tendencies are to include, after thorough evaluation of benefit - risk ratio, some new indications for fetal surgery.
胎儿手术，也被称为宫内、产前或子宫内手术，包括在胎儿期治疗先天性畸形。在子宫内生活中诊断出的畸形进行治疗的想法可以追溯到 1963 年，当时 Lilly 为胎儿进行了第一次输血。从那时起，它已作为一系列致命畸形的治疗选择被引入。人们正在努力通过胎儿手术来治疗非致命性畸形。
材料/方法：使用 MEDLINE 和 PubMed 在 1925 年至 2009 年 2 月之间进行了全面的文献搜索。MEDLINE 和 PubMed 的搜索词是：胎儿手术、胎儿手术、宫内手术、产前手术和宫内治疗。此外，还从国际医学和外科学会以及加利福尼亚大学胎儿治疗中心的网站获取了信息。
我们的注意力集中在胎儿手术历史、其发展和前景的总体看法上。此外，由于作者对整形外科学的兴趣，对宫内医学和外科在该医学分支中的作用作了一些评论。
宫内手术可以被视为预防医学的有效工具。它提供了其他医学分支无法提供的一些优势。然而，其实施比以前认为的更为麻烦。因此，只有选择的病例可能受益于其优势。尽管如此，目前的趋势是在彻底评估利弊比后，将一些新的胎儿手术适应证纳入其中。
