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Fetale Chirurgie

Fetal surgery

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Zusammenfassung

Die fetale Chirurgie ist ein neuer interdisziplinärer Fachbereich, der sich in spezialisierten Zentren mit der Therapie von wenigen, stark selektierten Patienten beschäftigt. Ziel dieser Bemühungen ist es, Fehlbildungen während der fetalen Entwicklung operativ zu korrigieren. Es soll verhindert werden, dass am Ende der Gestationsphase irreparable Schäden der betroffenen Organe und Systeme entstehen, die eine hohe Morbidität und Letalität beim Neugeborenen verursachen. Beispiele sind die Therapie der obstruktiven Uropathie, die unbehandelt zu einer Niereninsuffizienz führen würde, die Therapie der Lungenhypoplasie bei angeborener Zwerchfellhernie, großer kongenitaler zystischer adenomatoider Malformationen der Lunge und großer sakrokokzygealer Teratome. Die vorliegende Übersicht beschreibt grundsätzliche Prinzipien der fetalen Chirurgie, die pathophysiologischen Prozesse einiger fetalchirurgisch korrigierbarer Fehlbildungen sowie die diagnostischen und therapeutischen Ansätze. Die bisher veröffentlichten Ergebnisse werden dargestellt und kritisch diskutiert.

Abstract

Fetal surgery is a newly evolving multidisciplinary medical field, being performed in specialized centers. It deals with the treatment of selected fetuses with congenital anomalies that cause high morbidity and mortality. The aim of the surgical treatment is to avoid the development of progressive and eventually irreversible damage at birth. Examples of entities treated are obstructive uropathy leading to renal insufficiency, lung hypoplasia in severe congenital diaphragmatic hernia, severe congenital cystic adenomatoid malformation of the lung, and sacrococcygeal teratoma. This review describes principles of fetal surgery, physiopathologic processes of some of the anomalies treated in this way, and diagnostic and therapeutic approaches. Recently published results are presented and discussed.

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Authors and Affiliations

  1. Kinderchirurgische Universitätsklinik, Klinikum Mannheim, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg

    S. Hosie & C. Wollmann

  2. Institut für Klinische Radiologie, Klinikum Mannheim, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg

    W. Neff

  3. Kinderchirurgische Klinik, Universitätsklinikum Heidelberg

    S. Holland-Cunz

  4. Kinderchirurgische Universitätsklinik, Theodor-Kutzer Ufer 1–3, 68167 , Mannheim

    S. Hosie

Authors
  1. S. Hosie
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  2. C. Wollmann
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  3. W. Neff
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  4. S. Holland-Cunz
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Correspondence to S. Hosie.

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Hosie, S., Wollmann, C., Neff, W. et al. Fetale Chirurgie. Chirurg 76, 757–764 (2005). https://doi.org/10.1007/s00104-005-1065-3

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  • DOI: https://doi.org/10.1007/s00104-005-1065-3

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