OBJECTIVE: To compare outcomes of fetoscopic spina bifida aperta repair (FSBAR) with the results of the open approach (OSBAR) as in the Management Of Myelomeningocele Study (MOMS). METHODS: This was a systematic comparison of reports on FSBAR with data from the MOMS (n = 78). Inclusion criteria were studies of spina bifida aperta patients who underwent FSBAR and were followed for ≥12 months. Primary outcome was perinatal mortality. Secondary outcomes included operative, maternal, fetal, neonatal and infant outcomes. RESULTS: Out of 16 reports, we included 5 from 2 centers. Due to bias and heterogeneity, analysis was restricted to two overlapping case series (n = 51 and 71). In those, FSBAR was technically different from OSBAR, had comparable perinatal mortality (7.8 vs. 2.6%, p = 0.212) and shunt rate at 12 months (45 vs. 40%, p = 0.619), longer operation time (223 vs. 105 min, p < 0.001), higher preterm prelabor membrane rupture rate (84 vs. 46%, p < 0.001), earlier gestational age at birth (32.9 vs. 34.1 weeks, p = 0.03), higher postnatal reoperation rate (28 vs. 2.56%, p < 0.001) and absence of uterine thinning or dehiscence (0 vs. 36%, p < 0.001). Functional outcomes were not available. CONCLUSION: FSBAR utilizes a different neurosurgical technique, takes longer to complete, induces more prematurity, requires additional postnatal procedures, yet has a comparable shunt rate and is not associated with uterine thinning or dehiscence. Long-term functional data are awaited.
OBJECTIVE: To compare outcomes of fetoscopic spina bifida aperta repair (FSBAR) with the results of the open approach (OSBAR) as in the Management Of Myelomeningocele Study (MOMS). METHODS: This was a systematic comparison of reports on FSBAR with data from the MOMS (n = 78). Inclusion criteria were studies of spina bifida aperta patients who underwent FSBAR and were followed for ≥12 months. Primary outcome was perinatal mortality. Secondary outcomes included operative, maternal, fetal, neonatal and infant outcomes. RESULTS: Out of 16 reports, we included 5 from 2 centers. Due to bias and heterogeneity, analysis was restricted to two overlapping case series (n = 51 and 71). In those, FSBAR was technically different from OSBAR, had comparable perinatal mortality (7.8 vs. 2.6%, p = 0.212) and shunt rate at 12 months (45 vs. 40%, p = 0.619), longer operation time (223 vs. 105 min, p < 0.001), higher preterm prelabor membrane rupture rate (84 vs. 46%, p < 0.001), earlier gestational age at birth (32.9 vs. 34.1 weeks, p = 0.03), higher postnatal reoperation rate (28 vs. 2.56%, p < 0.001) and absence of uterine thinning or dehiscence (0 vs. 36%, p < 0.001). Functional outcomes were not available. CONCLUSION: FSBAR utilizes a different neurosurgical technique, takes longer to complete, induces more prematurity, requires additional postnatal procedures, yet has a comparable shunt rate and is not associated with uterine thinning or dehiscence. Long-term functional data are awaited.
Authors: Mano Shanmuganathan; Deborah A Sival; Kelly-Ann Eastwood; Katie Morris; Jacqueline Cartmill; Axel Heep; Janusz Bohosiewicz; Agnieszka Pastuszka; Alyson Hunter; Amanda Ali; Roy McConnell; Darach Crimmins; Fergal Malone; Carolyn Bailie; Jan Deprest; Cathy McKillop; Zarko Alfirevic; Fionnuala McAuliffe; Stephen Ong Journal: Ir J Med Sci Date: 2017-11-03 Impact factor: 1.568
Authors: Tuangsit Wataganara; Arundhati Gosavi; Katika Nawapun; Pradip D Vijayakumar; Nisarat Phithakwatchara; Mahesh Choolani; Lin Lin Su; Arijit Biswas; Citra N Z Mattar Journal: J Vis Exp Date: 2018-03-21 Impact factor: 1.355
Authors: Elke Januschek; Andreas Röhrig; Sandra Kunze; Christian Fremerey; Bea Wiebe; Martina Messing-Jünger Journal: Childs Nerv Syst Date: 2016-04-16 Impact factor: 1.475
Authors: Sandra K Kabagambe; Y Julia Chen; Melissa A Vanover; Payam Saadai; Diana L Farmer Journal: Childs Nerv Syst Date: 2017-05-11 Impact factor: 1.475
Authors: Luc Joyeux; Marjolijn Deprez; Ahmad Khatoun; Kris Van Kuyck; Kelly Pelsmaekers; Alexander C Engels; Hongmei Wang; Marina Gabriela Monteiro Carvalho Mori da Cunha; Stephanie De Vleeschauwer; Myles Mc Laughlin; Jan Deprest Journal: Sci Rep Date: 2017-11-23 Impact factor: 4.379