Kazunori Masahata1, Hideki Soh2, Kazuya Tachibana3, Jun Sasahara4, Masayuki Hirose5, Tadashi Yamanishi6, Souji Ibuka7, Hiroomi Okuyama8, Noriaki Usui2. 1. Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Murodoucho 840, Izumi, Osaka, 594-1101, Japan. masahata@wch.opho.jp. 2. Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Murodoucho 840, Izumi, Osaka, 594-1101, Japan. 3. Department of Anesthesiology, Osaka Women's and Children's Hospital, Izumi, Japan. 4. Department of Obstetrics, Osaka Women's and Children's Hospital, Izumi, Japan. 5. Department of Otolaryngology, Osaka Women's and Children's Hospital, Izumi, Japan. 6. Department of Oral and Maxillofacial Surgery, Osaka Women's and Children's Hospital, Izumi, Japan. 7. Department of Pediatric Surgery, National Hospital Organization Fukuyama Medical Center, Hiroshima, Japan. 8. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Abstract
PURPOSE: The aim of this study was to evaluate the indications and the clinical outcomes of the fetuses managed with ex utero intrapartum treatment (EXIT) procedures. METHODS: We retrospectively reviewed the medical records of all fetuses who underwent EXIT procedures between 2003 and 2018. RESULTS: EXIT procedures were performed in nine cases. The prenatal diagnosis of the neonates was congenital high airway obstruction syndrome in four cases, the neck masse in five cases. Although the airway management under the EXIT procedure was successful in eight cases, the airway management failed in one case. During the EXIT procedures, the airway was managed by endotracheal intubation in two cases, whereas six cases underwent tracheostomy. Six cases with fetal airway obstruction survived to discharge, whereas three cases died due to airway management failure or complications of the underlying disease. A case with a cervical teratoma underwent tumor resection the day after birth due to rapid enlargement of the neck mass. Long-term survival was achieved in five cases. CONCLUSIONS: We concluded that the EXIT procedure was effective and could be performed safely in the airway management of fetuses with suspected airway obstruction. The treatment strategy for the neck masses should be planned before birth.
PURPOSE: The aim of this study was to evaluate the indications and the clinical outcomes of the fetuses managed with ex utero intrapartum treatment (EXIT) procedures. METHODS: We retrospectively reviewed the medical records of all fetuses who underwent EXIT procedures between 2003 and 2018. RESULTS: EXIT procedures were performed in nine cases. The prenatal diagnosis of the neonates was congenital high airway obstruction syndrome in four cases, the neck masse in five cases. Although the airway management under the EXIT procedure was successful in eight cases, the airway management failed in one case. During the EXIT procedures, the airway was managed by endotracheal intubation in two cases, whereas six cases underwent tracheostomy. Six cases with fetal airway obstruction survived to discharge, whereas three cases died due to airway management failure or complications of the underlying disease. A case with a cervical teratoma underwent tumor resection the day after birth due to rapid enlargement of the neck mass. Long-term survival was achieved in five cases. CONCLUSIONS: We concluded that the EXIT procedure was effective and could be performed safely in the airway management of fetuses with suspected airway obstruction. The treatment strategy for the neck masses should be planned before birth.
Entities:
Keywords:
Cervical lymphatic malformation; Cervical teratoma; Congenital high airway obstruction syndrome; Epignathus; Ex utero intrapartum treatment
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