Link: https://www.ncbi.nlm.nih.gov/pubmed/30481746

Fetal Diagn Ther. 2018 Nov 27:1-10. doi: 10.1159/000491785. [Epub ahead of print]
Tracheal Diameter and Respiratory Outcome in Infants with Congenital Diaphragmatic Hernia Treated by Fetal Endoscopic Tracheal Occlusion.
Morandi A1, Macchini F2, Ophorst M3, Borzani I4, Ciralli F3, Farolfi A3, Porro GA5, Franzini S5, Fabietti I6, Persico N6, Mosca F7, Leva E2.
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Abstract
AIM:
To evaluate tracheal diameters and their clinical impact in patients with congenital diaphragmatic hernia (CDH) after fetal endoscopic tracheal occlusion (FETO).

METHODS:
Patients born with CDH between January 2012 and August 2016 were divided into two groups: noFETO and FETO. Tracheal diameters at three levels (T1, carina, and maximum tracheal dilation) on chest X-ray at 1, 3, 6, 12, 24, and 36 months of follow-up, requirements of invasive and noninvasive respiratory support, the incidence of respiratory infections, and results of pulmonary function tests (PFT) were compared.

RESULTS:
A total of 71 patients with CDH were born in the study period, and there were 34/41 survivors in the no-FETO group (82.9%) and 13/30 in the FETO group (43.3%). The maximum tracheal diameter was significantly greater in the FETO group at all ages. No differences were observed in the diameters at T1 and the carina, in the requirements of invasive and noninvasive respiratory support, and in the incidence respiratory infections. At the PFT (6-12 months), the FETO group presented higher respiratory rates (46.1 ± 6.2 vs. 36.5 ± 10.6, p = 0.02). No differences in PFT results were found between the groups after the 1st year of life.

CONCLUSIONS:
The FETO procedure leads to persistent tracheomegaly. However, the tracheomegaly does not seem to have a significant clinical impact.

© 2018 S. Karger AG, Basel.

KEYWORDS:
Congenital diaphragmatic hernia; Fetal endoscopic surgery; Fetal endoscopic tracheal occlusion; Fetal therapy; Tracheomegaly

PMID: 30481746 DOI: 10.1159/000491785