Standardized Technique for Full Laser Ablation of Feeding Artery in Fetuses With Bronchopulmonary Sequestration and Large Pleural Effusion: Lessons Learned Over 14 Years of Experience.

OBJECTIVE

To report on perinatal outcomes and technical aspects of standardized fetal surgery technique with full laser coagulation of the feeding artery in fetuses with bronchopulmonary sequestration and large pleural effusion.

METHOD: During a 14-year period, a prospective cohort of fetuses with BPS and large pleural effusion were selected for laser coagulation in a single national reference center for fetal surgery. Feasibility, perinatal outcomes, complications, survival, respiratory morbidity, and need for neonatal lung mass resection are reported.

RESULTS

29 fetuses were treated at a median gestational age of 28.4 weeks. Hydrops was present in 13 (44.8%) cases. In 2 fetuses (6.9%), an intrathoracic bleeding was observed during fetal intervention, one presenting with intrauterine demise at 23 weeks of gestation. Median gestational age at birth was 38.9 weeks. Two fetuses (6.9%) were born preterm (33 and 35 weeks). Neonatal respiratory morbidity was reported in 3 neonates requiring oxygen support and in 2 neonates requiring mechanical ventilation. One fetus required postnatal thoracic surgery. There were no neonatal deaths; hence, the overall survival rate was 96.6% (28/29).

CONCLUSIONS

Fetuses with BPS and large pleural effusion treated by laser coagulation of the feeding vessel have good perinatal outcomes and low risk of complications.