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Abstract：
The aim of this study was to review the perioperative complication rates and neonatal outcomes after fetoscopic release of amniotic bands that caused bilateral limb constrictions. We present 5 cases of limb constriction by amniotic bands occurring spontaneously or following fetoscopic surgery and also include a review of 21 previously published cases. The cases were analyzed for indication, surgical technique, and postoperative follow-up. In our population and the literature, the majority of the children acquired a functional limb (75%), with few perioperative complications (15%). Fetal morbidity was mainly linked to the consequences of preterm premature rupture of the membranes (38.4%) and preterm birth (34.7 GW). The mortality rate was low (7.7%). This review only describes amniotic bands causing limb constriction, and illustrates that fetoscopic surgery for their release is technically feasible with an acceptable perioperative complication rate. However, the 75% success rate is very likely to be an overestimation of the true success rate. In view of these observations we cannot recommend treatment for cases where the fetus has been extensively affected by the bands. We believe, however, that we could consider this technique for a fraction of amniotic band syndrome cases isolated to the limb constrictions. This kind of surgery should be proposed as a potential treatment for amniotic band syndrome.
摘要：
这项研究的目的是回顾胎儿镜下释放羊膜带引起双侧肢体收缩后的围手术期并发症发生率和新生儿结局。我们介绍了5例自发或在胎儿镜手术后发生的羊膜带引起的肢体收缩，还包括对21例先前发表的病例的回顾。对病例进行适应症分析，外科技术,术后随访。在我们的人口和文献中，大多数儿童获得了功能性肢体（75％），围手术期并发症少（15%）。胎儿发病率主要与早产胎膜早破（38.4％）和早产（34.7GW）的后果有关。死亡率低（7.7%）。这篇综述仅描述了羊膜带引起肢体收缩，并说明了在围手术期并发症发生率可接受的情况下，对其进行腹腔镜手术在技术上是可行的。然而,75%的成功率很可能是对真正成功率的高估。鉴于这些观察结果，我们不能建议对胎儿受到带广泛影响的情况进行治疗。我们相信,然而,我们可以考虑将这种技术用于隔离到肢体收缩的羊膜带综合征病例的一部分。应建议将这种手术作为羊膜带综合征的潜在治疗方法。
