2026-01-19 国立成育医療研究センター
【図:先天性横隔膜ヘルニアの胎児治療イメージ】
<関連情報>
- https://www.ncchd.go.jp/press/2026/0119.html
- https://www.ncchd.go.jp/press/2026/0119.pdf
- https://karger.com/fdt/article-abstract/doi/10.1159/000548340/934452/The-Outcomes-and-Lung-Changes-of-Fetoscopic
横隔膜ヘルニア胎児に対する胎児鏡下気管内腔閉塞術の転帰と肺の変化:日本における単一施設での経験 The Outcomes and Lung Changes of Fetoscopic Endoluminal Tracheal Occlusion in Fetus with Diaphragmatic Hernia: A Single-Center Experience in Japan
Jin Muromoto;Katsusuke Ozawa;Rika Sugibayashi;Shoichiro Amari;Seiji Wada;Yutaka Kanamori;Yushi Ito;Haruhiko Sago
Fetal Diagnosis and Therapy Published:September 08 2025
DOI:https://doi.org/10.1159/000548340
Abstract
Introduction: The aim of this study was to evaluate the outcomes with lung changes of fetoscopic endoluminal tracheal occlusion (FETO) for congenital diaphragmatic hernia (CDH). Methods: Between 2014 and 2023, we performed FETO for severe or moderate left-sided CDH with the Kitano grade 3 stomach position. We analyzed the pre- and postoperative ultrasound findings, pregnancy outcomes, and survival rates at 6 months. Results: Twenty-five patients were analyzed. The median gestational age at balloon insertion was 29.1 (range: 27.1–31.8) weeks. The median gestational age at delivery was 35.7 (range: 30.7–38.7) weeks. Pulmonary hypertension was observed in 71% (15/21) of the cases. The 6-month survival rate was 40% (10/25). The post-FETO observed-to-expected lung area-to-head circumference ratio (o/e LHR) and differences between pre- and post-FETO values were significantly higher in survivors than in infants who died (p < 0.01 and p < 0.01, respectively), but pre-FETO values were not. The post-FETO cutoff value associated with the 6-month survival was 33.8%, and that of the difference between pre- and post-FETO o/e LHR was 7.8% (area under the curve = 0.91 and 0.86, respectively). Conclusions: FETO can lead to an increased o/e LHR in some but not all CDH fetuses, reflecting fetal lung growth, and be associated with a survival when it exceeds the threshold.
