Sequential Laser Surgery for Twin-Twin Transfusion Syndrome

被引:11
|
作者
Chmait, Ramen H. [1 ]
Kontopoulos, Eftichia V. [2 ]
Quintero, Ruben A. [2 ]
机构
[1] Univ So Calif, Keck Sch Med, Dept Obstet & Gynecol, Div Maternal Fetal Med, Los Angeles, CA 90027 USA
[2] Jackson Mem Hosp, Jackson Fetal Therapy Inst, Div Maternal Fetal Med & Fetal Surg, Miami, FL 33136 USA
关键词
laser surgery; laser photocoagulation of communicating vessels; TTTS; twin-twin transfusion syndrome; operative fetoscopy; PEAK SYSTOLIC VELOCITY; COMMUNICATING VESSELS; PHOTOCOAGULATION;
D O I
10.1055/s-0034-1382774
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Treatment of twin-twin transfusion syndrome (TTTS) via the sequential selective laser photocoagulation of communicating vessels (SQLPCV) technique involves lasering the arteriovenous communications from the donor twin to the recipient twin first, followed by the arteriovenous communications from the recipient twin to the donor. Occluding the vascular communications in this particular order may result in transient intraoperative net transfusion to the donor twin and facilitate hemodynamic equilibrium, particularly to the volume depleted donor twin. Preliminary evidence suggests that the SQLPCV technique may result in improved perinatal outcomes compared with the standard selective (SLPCV) laser surgical approach. In this article, we describe the pathophysiological basis for this surgical approach, delineate the surgical technique, review the literature, and elaborate on the outstanding questions of the SQLPCV treatment of TTTS.
引用
收藏
页码:S13 / S18
页数:6
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