Clayton Douglass B, Brock John W
Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, 2200 Children's Way, 4102 Doctor's Office Tower, Nashville, TN, 37232, USA.
Curr Urol Rep. 2018 Feb 22;19(1):12. doi: 10.1007/s11934-018-0760-9.
In this article, we explore the origins of intervention of fetal lower urinary tract obstruction, and we specifically discuss the background and recent outcomes of vesicoamniotic shunt placement and fetal cystoscopy. The article seeks to provide a comprehensive overview of the field while bringing the reader quickly up to speed on the pertinent literature and the critical data that are available to guide decision-making regarding intervention.
Appropriate patient selection for fetal intervention remains challenging despite advances in prenatal imaging. Both a randomized controlled trial and multiple systematic reviews show evidence of a perinatal survival benefit following fetal intervention but rates of renal morbidity remain very high. Despite 30 years of research, fetal lower urinary tract obstruction remains a difficulty entity to treat. Intervention may lead to survival, but physicians and caregivers must remain alert for the distinct possibility of long-term renal morbidity in survivors.
在本文中，我们探讨胎儿下尿路梗阻干预的起源，并特别讨论羊膜腔分流置管术和胎儿膀胱镜检查的背景及近期结果。本文旨在全面概述该领域，同时使读者迅速了解相关文献以及可用于指导干预决策的关键数据。
尽管产前影像学取得了进展，但为胎儿干预选择合适的患者仍然具有挑战性。一项随机对照试验和多项系统评价均显示胎儿干预后围产期生存获益的证据，但肾脏发病率仍然很高。尽管经过30年的研究，胎儿下尿路梗阻仍然是一个难以治疗的疾病。干预可能会带来生存，但医生和护理人员必须警惕幸存者出现长期肾脏疾病的明显可能性。
