Mesas Burgos Carmen, Tiblad Eleonor, Papatziamos Georgios, Jörnvall Henrik, Conner Peter
Karolinska Universitetssjukhuset - Pediatric Surgery Stockholm, Sweden Karolinska Universitetssjukhuset - Pediatric Surgery Stockholm, Sweden.
Karolinska Universitetssjukhuset - Stockholm, Sweden Karolinska Universitetssjukhuset - Stockholm, Sweden.
Lakartidningen. 2019 May 15;116:FHWM.
The main, but not sole, indication for an Ex-utero Intrapartum Treatment (EXIT) delivery is an airway obstruction due to either laryngeal atresia or tumors in the head and neck region. Here we present our Institution's experience with eleven cases: three teratomas, four lymphatic malformations, two laryngeal atresias and two dermoid cysts. The EXIT procedure was used to secure the fetal airway while maintaining uteroplacental gas exchange and fetal hemodynamic stability through the umbilical circulation. Five fetuses required tracheostomy. Only one fetal death occurred due to extensive growth of a teratoma preventing us from establishing an airway. No other fetal or major maternal complication occurred. The EXIT procedure is a complex procedure and these rare cases should be referred to a center with a dedicated and experienced multidisciplinary team.
产时宫外治疗(EXIT)分娩的主要但并非唯一的指征是由于喉闭锁或头颈部肿瘤导致的气道阻塞。在此,我们介绍本机构11例病例的经验:3例畸胎瘤、4例淋巴管畸形、2例喉闭锁和2例皮样囊肿。EXIT手术用于确保胎儿气道安全,同时通过脐循环维持子宫胎盘气体交换和胎儿血流动力学稳定。5例胎儿需要气管切开术。仅1例胎儿死亡,原因是畸胎瘤广泛生长,导致我们无法建立气道。未发生其他胎儿或严重的母体并发症。EXIT手术是一个复杂的手术,这些罕见病例应转诊至拥有专业且经验丰富的多学科团队的中心。