Prenatal therapy for thoracic and mediastinal lesions.
Most prenatally diagnosed lung lesions can be managed successfully during the neonatal period. Prenatal imaging and experimental models have provided a comprehensive understanding of the pathophysiology, natural history, and prognosis of intrathoracic and mediastinal lesions. Clinical experience has demonstrated that progression to nonimmune hydrops fetalis and pulmonary hypoplasia is a harbinger of fetal or neonatal demise. Advances in fetal anesthesia, tocolysis, and surgical techniques have made fetal surgery a viable in utero option to ameliorate life-threatening masses. Congenital cystic adenomatoid malformation, bronchopulmonary sequestration, and congenital hydrothorax are the most common abnormalities amenable to surgical intervention. The natural history, evaluation, and treatment of intrathoracic and mediastinal lesions are discussed.
Tsao
KuoJen
K
The Fetal Treatment Center, Division of Pediatric Surgery, University of California, San Francisco Medical Center, 513 Parnassus Avenue, HSW-1601, San Francisco, California 94143-0570, USA.
Albanese
Craig T
CT
Harrison
Michael R
MR
D000465:Algorithms; D001998:Bronchopulmonary Sequestration / Q000601:surgery; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000196:embryology / Q000601:surgery; D005315:Fetal Diseases / Q000601:surgery*; D005333:Fetus / Q000601:surgery*; D006801:Humans; D006876:Hydrothorax / Q000151:congenital; D008168:Lung / Q000473:pathology; D008479:Mediastinal Neoplasms / Q000601:surgery*; D011379:Prognosis; D013896:Thoracic Diseases / Q000601:surgery*