Treatment of a Fetal Tracheal Obstruction by Fetoscopy and Laser.
Fiche publication
Date publication
janvier 2015
Journal
Fetal diagnosis and therapy
Auteurs
Membres identifiés du Cancéropôle Est :
Pr AKLADIOS Chérif
Tous les auteurs :
Bel S, Sananes N, Gaudineau A, Akladios C, Favre R
Lien Pubmed
Résumé
We report below a case of in utero tracheoscopy with laser collapse of a bronchogenic cyst obstructing the fetal trachea. The patient was referred for ultrasonography at 24 weeks of gestation because of fetal hydrops. Tracheoscopy was performed via fetoscopic approach using a single trocar under local anesthesia with lidocaine and ultrasound guidance. This revealed an image suggestive of a cyst obstructing the middle third at the anterior base of the trachea. Coagulation using a diode laser enabled us to collapse this fluid-filled cyst with three 10-watt bursts (3 times 3 s) and to visualize a completely unobstructed tracheobronchial tree with significant pulmonary fluid reflux on removal of the obstacle. The fetal condition improved markedly within 48 h after the procedure. To the best of our knowledge, this is the first described case of in utero treatment of a tracheal obstruction by tracheoscopy and laser. In severe cases of obstruction of the fetal airways, whether the obstacle is situated in a high or low position, fetal endoscopy is of diagnostic and potentially therapeutic utility.
Mots clés
Adult, Airway Obstruction, diagnostic imaging, Female, Fetoscopy, Humans, Mediastinal Cyst, diagnostic imaging, Pregnancy, Ultrasonography, Prenatal
Référence
Fetal Diagn Ther. 2015 01 31;40(1):63-6