Outcomes of infants followed-up at least 12 months after fetal open and endoscopic surgery for meningomyelocele: a systematic review and meta-analysis.
OBJECTIVE
To assess the outcomes of infants followed-up at least 12 months after open and endoscopic fetal surgery for the treatment of spina bifida.


METHODS
A searching in The Cochrane Library, LILACS, PubMed and SCOPUS databases for fetal meningomyelocele (MMC) open or endoscopic surgery in humans from 2003 on-wards with follow-up at least 12 months. The rate of the estimated proportions was evaluated by the 95% confidence interval (CI).


RESULTS
A total of 19 studies were finally included (17 open and 2 endoscopic surgery). The results suggested that the rate for ventriculoperitoneal shunt placement were 40% (29%, 51%) versus 45% (34%, 56%) for open surgery group and endoscopic surgery group. The rate of hindbrain herniation reversal was 34% (28%, 52%) versus 86% (49%, 97%), the lower extremity function rates for both groups were 47% (30%, 64%) versus 86% (49%, 97%), and bladder dysfunction rates for both groups were 72% (53%, 88%) versus 29% (8%, 64%), respectively. Open and endoscopic fetal surgery for MMC presented similar ventriculoperitoneal shunt rates.


CONCLUSIONS
Open and endoscopic fetal surgery for MMC presented similar ventriculoperitoneal shunt rates in infants followed at least 12 months.
Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
Edward
E
Araujo Júnior
Department of Obstetrics and Gynecology, Guastalla Civil Hospital, AUSL Reggio Emilia, Italy.
Gabriele
G
Tonni
Department of Obstetrics and Gynecology, Ribeirão Preto School of Medicine, São Paulo University (FMRP-USP), Ribeirão Preto, SP, Brazil.
Wellington P
WP
Martins
Fetal surgery; follow-up; meningomyelocele; meta-analysis; ventriculoperitoneal shunt