EP14.04: Outcomes of fetoscopic laser surgery for Twin–twin transfusion syndrome: a single‐centre experience in Japan

The aim of study was to evaluate the outcomes of fetoscopic laser photocoagulation (FLP) for Twin–twin transfusion syndrome (TTTS) in our hospital. The retrospective cohort study was conducted in 179 TTTS cases undergoing FLP with confirmed perinatal outcomes between 2015 and 2023. Data were extracted from medical records for a retrospective analysis. During the study period, 179 cases with known delivery outcomes underwent FLP. The FLP procedures were performed under epidural and spinal subarachnoid anesthesia in all cases. The coagulation technique involved the modified sequential method combined with the Solomon method in all cases. Three cases were not able to be competed FLP. Median maternal age was 33 years (20-50), and Quintero Stages were: I, 58 cases (33.0%); II, 53 cases (30.1%); III, 61 cases (34.7%); IV, 4 cases (2.3%). Median gestational age(GA) at surgery was 21.1 weeks (15.8-29.0), with a median operation time of 48 minutes (20-180). The median GA at delivery was 34.1 weeks (22.3-40.4). Survival rates were: both twins, 145 cases (82.4%); at least one twin, 172 cases (97.7%); one twin, 27 cases (15.3%); recipient survival, 155 cases (88.0%); donor survival, 162 cases (84.0%). Intrauterine fetal death occurred in both twins in 1 case (1.3%), one twin in 27 cases (15.3%), with 21 cases (11.9%) in recipients and 14 cases (8.0%) in donors. Postoperative pregnancy terminations were absent, and the miscarriage rate was 1.1% (3 cases). The median treatment-delivery interval was 84.5 days (1-150). Median birthweight was recipient: 1940g (414-3134g), donor: 1575g (339-3006g). Our institution's outcomes were comparable to previous studies, demonstrating a notably high survival rate for at least one infant.