Fetal Interventions: A Closer Look at Fetoscopic Laser Surgery: A Literature Review
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Tipo de documento: | Dissertação |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.6/13566 |
Resumo: | Over the past decades, due to the advances in imaging methods, prenatal diagnosis of congenital malformations has become widely available. Simultaneously with the improvement of surgical techniques and the development of instrumentation technology, fetal treatment of these pathologies became possible, arising as an alternative to the standard postnatal therapy, aiming to improve fetal outcomes and optimize the transition into neonatal life. Thus, fetal surgery emerges, comprising open interventions and minimally invasive procedures, such as fetoscopy. Fetoscopic surgery, or fetal endoscopic surgery, is a technique that uses endoscopic technology to correct structural and/or functional fetal anomalies in utero, under continuous ultrasound guidance. Fetoscopy is mainly performed percutaneously and allows direct visualization of the fetus and adjacent structures. Nowadays, fetal surgery is most commonly indicated in the treatment of twinto-twin transfusion syndrome, a complication of monochorionic twin pregnancies, using laser coagulation. However, fetoscopic laser surgery can also be performed for the management of other conditions affecting monochorionic pregnancies, such as twin anemia polycythemia sequence and twin reversed arterial perfusion sequence, as well as several other pathologies including amniotic band syndrome, lower urinary tract obstruction, congenital high airway obstruction syndrome, chorioangiomas, and sacrococcygeal teratomas. The aim of this literature review is to provide a brief overview of the most common fetal interventions and to describe fetoscopic laser surgery, covering its indications, techniques, and outcomes following fetal treatment. |
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Fetal Interventions: A Closer Look at Fetoscopic Laser Surgery: A Literature ReviewCirurgia FetalCirurgia Fetoscópica a LaserFetoscopiaIntervenção IntrauterinaProcedimento Minimamente InvasivoDomínio/Área Científica::Ciências Médicas::Ciências da Saúde::MedicinaOver the past decades, due to the advances in imaging methods, prenatal diagnosis of congenital malformations has become widely available. Simultaneously with the improvement of surgical techniques and the development of instrumentation technology, fetal treatment of these pathologies became possible, arising as an alternative to the standard postnatal therapy, aiming to improve fetal outcomes and optimize the transition into neonatal life. Thus, fetal surgery emerges, comprising open interventions and minimally invasive procedures, such as fetoscopy. Fetoscopic surgery, or fetal endoscopic surgery, is a technique that uses endoscopic technology to correct structural and/or functional fetal anomalies in utero, under continuous ultrasound guidance. Fetoscopy is mainly performed percutaneously and allows direct visualization of the fetus and adjacent structures. Nowadays, fetal surgery is most commonly indicated in the treatment of twinto-twin transfusion syndrome, a complication of monochorionic twin pregnancies, using laser coagulation. However, fetoscopic laser surgery can also be performed for the management of other conditions affecting monochorionic pregnancies, such as twin anemia polycythemia sequence and twin reversed arterial perfusion sequence, as well as several other pathologies including amniotic band syndrome, lower urinary tract obstruction, congenital high airway obstruction syndrome, chorioangiomas, and sacrococcygeal teratomas. The aim of this literature review is to provide a brief overview of the most common fetal interventions and to describe fetoscopic laser surgery, covering its indications, techniques, and outcomes following fetal treatment.Nas últimas décadas, a evolução da técnica imagiológica permitiu o diagnóstico pré-natal de um maior número de malformações congénitas. Simultaneamente com os avanços da técnica cirúrgica e dos próprios instrumentos utilizados, o tratamento fetal destas patologias surge como uma alternativa às opções terapêuticas pós-natais, de modo a melhorar o prognóstico neonatal e otimizar a transição do feto à vida extrauterina. Deste modo, a cirurgia fetal torna-se uma realidade, abrangendo procedimentos por via aberta e intervenções minimamente invasivas, como a fetoscopia. A cirurgia fetoscópica, ou cirurgia endoscópica fetal, consiste na utilização de técnicas de endoscopia para a correção de anomalias estruturais e/ou funcionais do feto, com o auxílio de monitorização ecográfica contínua. A fetoscopia é uma intervenção realizada maioritariamente por abordagem percutânea, permitindo a visualização direta do feto e estruturas adjacentes. Atualmente, a cirurgia fetal mais frequentemente realizada tem como indicação a síndrome de transfusão feto-fetal, complicação da gravidez gemelar monocoriónica, recorrendo à fetoscopia com coagulação a laser. A cirurgia fetal a laser pode também ser uma opção terapêutica noutras complicações das gestações gemelares monocoriónicas, como na sequência anemia-policitemia gemelar e na sequência de perfusão arterial reversa gemelar. Além destas patologias, o tratamento fetoscópico a laser foi também descrito na síndrome da banda amniótica, uropatia obstrutiva, síndrome de obstrução congénita das vias aéreas superiores, corioangioma e teratoma sacrococcígeo. Esta revisão bibliográfica pretende explorar os diferentes tipos de cirurgia fetal, focando-se na descrição da técnica da cirurgia fetoscópica a laser, bem como nas suas indicações e diferentes prognósticos após a intervenção fetal.Martins, Renato Alessandre SilvauBibliorumPereira, Inês de Bastos Marques2023-11-08T16:02:11Z2023-07-032023-04-212023-07-03T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/10400.6/13566TID:203375696enginfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-12-15T09:57:13Zoai:ubibliorum.ubi.pt:10400.6/13566Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T00:52:58.723229Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Fetal Interventions: A Closer Look at Fetoscopic Laser Surgery: A Literature Review |
title |
Fetal Interventions: A Closer Look at Fetoscopic Laser Surgery: A Literature Review |
spellingShingle |
Fetal Interventions: A Closer Look at Fetoscopic Laser Surgery: A Literature Review Pereira, Inês de Bastos Marques Cirurgia Fetal Cirurgia Fetoscópica a Laser Fetoscopia Intervenção Intrauterina Procedimento Minimamente Invasivo Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina |
title_short |
Fetal Interventions: A Closer Look at Fetoscopic Laser Surgery: A Literature Review |
title_full |
Fetal Interventions: A Closer Look at Fetoscopic Laser Surgery: A Literature Review |
title_fullStr |
Fetal Interventions: A Closer Look at Fetoscopic Laser Surgery: A Literature Review |
title_full_unstemmed |
Fetal Interventions: A Closer Look at Fetoscopic Laser Surgery: A Literature Review |
title_sort |
Fetal Interventions: A Closer Look at Fetoscopic Laser Surgery: A Literature Review |
author |
Pereira, Inês de Bastos Marques |
author_facet |
Pereira, Inês de Bastos Marques |
author_role |
author |
dc.contributor.none.fl_str_mv |
Martins, Renato Alessandre Silva uBibliorum |
dc.contributor.author.fl_str_mv |
Pereira, Inês de Bastos Marques |
dc.subject.por.fl_str_mv |
Cirurgia Fetal Cirurgia Fetoscópica a Laser Fetoscopia Intervenção Intrauterina Procedimento Minimamente Invasivo Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina |
topic |
Cirurgia Fetal Cirurgia Fetoscópica a Laser Fetoscopia Intervenção Intrauterina Procedimento Minimamente Invasivo Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina |
description |
Over the past decades, due to the advances in imaging methods, prenatal diagnosis of congenital malformations has become widely available. Simultaneously with the improvement of surgical techniques and the development of instrumentation technology, fetal treatment of these pathologies became possible, arising as an alternative to the standard postnatal therapy, aiming to improve fetal outcomes and optimize the transition into neonatal life. Thus, fetal surgery emerges, comprising open interventions and minimally invasive procedures, such as fetoscopy. Fetoscopic surgery, or fetal endoscopic surgery, is a technique that uses endoscopic technology to correct structural and/or functional fetal anomalies in utero, under continuous ultrasound guidance. Fetoscopy is mainly performed percutaneously and allows direct visualization of the fetus and adjacent structures. Nowadays, fetal surgery is most commonly indicated in the treatment of twinto-twin transfusion syndrome, a complication of monochorionic twin pregnancies, using laser coagulation. However, fetoscopic laser surgery can also be performed for the management of other conditions affecting monochorionic pregnancies, such as twin anemia polycythemia sequence and twin reversed arterial perfusion sequence, as well as several other pathologies including amniotic band syndrome, lower urinary tract obstruction, congenital high airway obstruction syndrome, chorioangiomas, and sacrococcygeal teratomas. The aim of this literature review is to provide a brief overview of the most common fetal interventions and to describe fetoscopic laser surgery, covering its indications, techniques, and outcomes following fetal treatment. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-11-08T16:02:11Z 2023-07-03 2023-04-21 2023-07-03T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
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http://hdl.handle.net/10400.6/13566 TID:203375696 |
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eng |
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eng |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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