EN
TÜRKÇE
Oral Presentation - 2
FETOSCOPIC TRACHEAL OCCLUSION. EXPERIENCE IN A HIGH COMPLEXITY UNIVERSITY HOSPITAL
MM Urquizo Lino, J Camacho
Department of Pediatric Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
INTRODUCTION:
Fetoscopic tracheal occlusion (FETO) is indicated for the treatment of moderate to severe congenital diaphragmatic hernia (CDH), especially when presenting with severe pulmonary hypoplasia and a poor survival prognosis. This technique aims to improve fetal lung development and survival rates at birth. Objective: To show the results of patients undergoing FETO in a single center.
MATERIALS AND METHODS:
Retrospective analysis of fetuses with CDH treated with endotracheal occlusion by fetal tracheoscopy. Pre- and post-procedure observed/expected lung-head ratios (O/E LHR), liver and stomach positions, gestational age (GA) at balloon placement and removal, maternal complications, and perinatal outcomes were recorded.
RESULTS:
9 patients treated between 2021 and 2024 were included. Two CDHs were right-sided. The median O/E LHR was 27.4% (moderate-severe herniation), with the liver herniated in all cases. The median GA at balloon placement was 29 weeks, and removal was performed at 32 weeks. The median duration of endotracheal balloon placement was 24 days. There were no maternal complications. One fetus with right-sided CDH died in utero from severe hydrops. Three patients died in the postnatal stage, two due to severe pulmonary hypoplasia, and one due to neonatal sepsis at 27 days.
DISCUSSION AND CONCLUSIONS:
Balloon placement and removal by fetal tracheoscopy were safe and feasible in all cases, with no fetal or maternal complications. FETO is an effective intervention for moderate to severe CDH. The benefits, risks, complications and potential decisions must be carefully evaluated by a multidisciplinary Fetal Medicine team.