1 Ocak 2023 Dergi makalesi Açık Erişim

Peiro, Jose L.; Duru, Soner; Fernandez-Tome, Blanca; Peiro, Lucas; Encinas, Jose L.; Sanchez-Margallo, Francisco M.; Oria, Marc

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    "creators": [
      {
        "name": "Peiro, Jose L."
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      {
        "affiliation": "Cincinnati Childrens Hosp Med Ctr CCHMC, Ctr Fetal & Placental Res, Div Pediat Gen & Thorac Surg, Cincinnati, OH USA", 
        "name": "Duru, Soner"
      }, 
      {
        "affiliation": "Jesus Uson Minimally Invas Surg Ctr JUMISC, Caceres, Spain", 
        "name": "Fernandez-Tome, Blanca"
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      {
        "name": "Peiro, Lucas"
      }, 
      {
        "affiliation": "Hosp La Paz, Dept Pediat Surg, Madrid, Spain", 
        "name": "Encinas, Jose L."
      }, 
      {
        "affiliation": "Jesus Uson Minimally Invas Surg Ctr JUMISC, Caceres, Spain", 
        "name": "Sanchez-Margallo, Francisco M."
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      {
        "name": "Oria, Marc"
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    "description": "<p>BACKGROUND:Congenital obstructive hydrocephalus generates progressive irreversible fetal brain damage by ventricular enlargement and incremental brain tissue compression that leads to maldevelopment and poor clinical outcomes. Intrauterine treatments such as ventriculo-amniotic shunting have been unsuccessfully tried in the eighties.OBJECTIVE:To assess if prenatal endoscopic third ventriculostomy (ETV) is feasible in a large animal model and optimize this technique for ventricular decompression and potential arrest of fetal brain damage in fetal lambs.METHODS:We generated hydrocephalus in 50 fetal lambs by injecting a polymeric agent into the cisterna magna at midgestation (E85). Subsequently, 3 weeks later (E105), fetal ETV was performed using a small rigid fetoscope. The endoscopy entry point was located anterior to the coronal suture, 7 mm from the midline.RESULTS:We obtained clear visualization of the enlarged lateral ventricles by endoscopy in the hydrocephalic fetal lambs. The floor of the third ventricle was bluntly perforated and passed with the scope for a successful ETV. Total success was achieved in 32/50 cases (64%). Causes of failure were blurred vision or third ventricle obliteration by BioGlue in 10/50 (20%) cases, anatomic misdirection of the endoscope in 5 (10%) cases, 2 cases of very narrow foramen of Monro, and 1 case of choroid plexus bleeding. If we exclude the cases artificially blocked by the polymer, we had a successful performance of prenatal-ETV in 80% (32/40) of hydrocephalic fetuses.CONCLUSION:Despite the inherent difficulties arising from ovine brain anatomy, this study shows that innovative fetal ETV is technically feasible in hydrocephalic fetal lambs.</p>", 
    "doi": "10.1227/neu.0000000000002361", 
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    "journal": {
      "issue": "6", 
      "pages": "9", 
      "title": "NEUROSURGERY", 
      "volume": "92"
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    "license": {
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    "publication_date": "2023-01-01", 
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    "resource_type": {
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      "title": "Dergi makalesi", 
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    "science_branches": [
      "Di\u011fer"
    ], 
    "title": "Fetal Endoscopic Third Ventriculostomy Is Technically Feasible in Prenatally Induced Hydrocephalus Ovine Model"
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