{"id":932,"date":"2016-03-11T16:39:14","date_gmt":"2016-03-11T16:39:14","guid":{"rendered":"http:\/\/wp.cs.ucl.ac.uk\/gift-surg-intranet\/?p=932"},"modified":"2016-03-11T16:39:14","modified_gmt":"2016-03-11T16:39:14","slug":"spina-bifida-fetal-surgery","status":"publish","type":"post","link":"https:\/\/wp1.cs.ucl.ac.uk\/gift-surg-intranet\/2016\/03\/11\/spina-bifida-fetal-surgery\/","title":{"rendered":"L. Joyeux: Article published on February 23, 2016 in Fetal Diagnosis and Therapy"},"content":{"rendered":"

Fetoscopic versus Open Repair for Spina Bifida Aperta: A Systematic Review of Outcomes<\/strong><\/p>\n

Luc Joyeux (a, b), Alexander C. Engels (a, b), Francesca M. Russo (a, b), Julio Jimenez (a, e), Tim Van Mieghem (a, c), Paolo De Coppi (a, f, g),\u00a0 Frank Van Calenbergh (d), Jan Deprest (a\u2013c, h).
\nKU Leuven and UCL<\/p>\n

ABSTRACT<\/p>\n

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).<\/p>\n

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.<\/p>\n

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.<\/p>\n

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.<\/p>\n","protected":false},"excerpt":{"rendered":"

Fetoscopic versus Open Repair for Spina Bifida Aperta: A Systematic Review of Outcomes Luc Joyeux (a, b), Alexander C. Engels (a, b), Francesca M. Russo (a, b), Julio Jimenez (a, e), Tim Van Mieghem (a, c), Paolo De Coppi (a,<\/p>\n","protected":false},"author":35,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-932","post","type-post","status-publish","format-standard","hentry","category-electronic-journal"],"yoast_head":"\nArticle published on Feb. 2016 in Fetal Diagnosis and Therapy<\/title>\n<meta name=\"description\" content=\"Joyeux L, Engels AC, Russo FM, Jimenez J, Van Mieghem T, De Coppi P, Van Calenbergh F, Deprest J. Fetoscopic versus Open Repair for Spina Bifida Aperta: A Systematic Review of Outcomes. Fetal Diagn Ther. 2016 Feb 23. [Epub ahead of print] PubMed PMID: 26901156.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/wp1.cs.ucl.ac.uk\/gift-surg-intranet\/2016\/03\/11\/spina-bifida-fetal-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Article published on Feb. 2016 in Fetal Diagnosis and Therapy\" \/>\n<meta property=\"og:description\" content=\"Joyeux L, Engels AC, Russo FM, Jimenez J, Van Mieghem T, De Coppi P, Van Calenbergh F, Deprest J. Fetoscopic versus Open Repair for Spina Bifida Aperta: A Systematic Review of Outcomes. Fetal Diagn Ther. 2016 Feb 23. 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