Laser for the treatment of twin to twin transfusion syndrome

Acta Cirurgica Brasileira

Denise Araújo Lapa Pedreira¹  Gregório Lorenzo Acácio¹  Carolina Leite Drummond¹  Rita De Cássia Sanchez E Oliveira¹  Alice D'agostini Deustch¹  Wladimir Guimarães Taborda¹ 

[1] ,Albert Einstein HospitalSão Paulo,Brazil

关键词: Fetofetal Transfusion;    Laser Coagulation;    Arteriovenous Anastomosis;    Twins;    Monozygotic;    Fetoscopy;    Diseases in Twins;    Transfusão Feto-Fetal;    Coagulação por Laser;    Anastomose Arteriovenosa;    Gêmeos Monozigóticos;    Fetoscopia;    Doenças em Gêmeos;   

DOI  :  10.1590/S0102-86502005000600015

来源: SciELO

【 摘 要 】

PURPOSE: To report the initial experience in our country with a new technique for twin to twin transfusion syndrome (TTTS) treatment, using laser to coagulate the placental vessels responsible for the twin transfusion during gestation. METHODS: Prospective study of eight cases diagnosed with TTTS evaluated in our service from january 2001 to june 2005. Through percutaneous introduction of a 2,0mm diameter fetoscope in the uterine cavity, placental surface vessels where directly visualized. Those identified as responsible for the transfusion were laser coagulated. The procedure combines ultrasonography and fetoscopy, in a so-called sonoendoscopic technique (FETENDO). RESULTS: Among the eight pregnancies evaluated, five cases were submitted to the procedure (10 fetuses). All fetuses survived for at least five weeks after surgery. A total of eight fetuses were born alive and five survived the neonatal period. In a 18 months follow-up after birth, all five are still alive and well and their mean age is now 10,6 months. The total survival rate was 50% and in three pregnancies, at least one fetus survived. CONCLUSIONS: Laser fetoscopy is actually the "gold-standard" treatment of TTTS. Nevertheless is a sophisticated technique that epends of proper training. Our service is the first in our country to offer this therapeutic technique. Our success rate is comparable with the international literature.

【 授权许可】

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