Vrecenak Jesse D, Flake Alan W
Center for Fetal Diagnosis and Therapy, Department of Surgery, Children's Hospital of Philadelphia, Abramson Research Bldg, Rm 1116B, 3615 Civic Center Blvd, Philadelphia, PA 19104-4318, USA.
Pediatr Surg Int. 2013 May;29(5):407-17. doi: 10.1007/s00383-013-3304-x. Epub 2013 Apr 4.
Building upon over 30 years of experimental and clinical development, fetal surgery can be argued to be a standard of care for selected indications, though application of these techniques remains limited to a small number of highly selected fetuses, and availability to a small number of highly specialized centers. Despite its limited application to date, the field of fetal surgery continues to evolve, spurred both by technological advances allowing earlier and more accurate diagnosis of fetal anomalies as well as improved capability to intervene when appropriate. The efficacy of fetal surgical intervention has now been validated for selected indications by well-designed, randomized controlled trials. In this review, we summarize the evidence or lack thereof supporting the current most common indications for fetal surgical intervention.
基于30多年的实验和临床发展，胎儿手术可以说是针对特定适应症的一种标准治疗方法，尽管这些技术的应用仍然仅限于少数经过严格筛选的胎儿，并且只有少数高度专业化的中心能够开展。尽管迄今为止其应用有限，但胎儿手术领域仍在不断发展，这既得益于技术进步，使得能够更早、更准确地诊断胎儿异常，也得益于在适当的时候进行干预的能力得到了提高。胎儿手术干预的疗效现已通过精心设计的随机对照试验在特定适应症上得到了验证。在本综述中，我们总结了支持或不支持当前胎儿手术干预最常见适应症的证据。
