Standardized Technique for Full Laser Ablation of Feeding Artery in Fetuses With Bronchopulmonary Sequestration and Large Pleural Effusion: Lessons Learned Over 14 Years of Experience

OBJECTIVE: To report on perinatal outcomes and technical aspects of standardized fetal surgery technique with full laser coagulation of the feeding artery in fetuses with bronchopulmonary sequestration and large pleural effusion. METHOD: During a 14-year period, a prospective cohort of fetuses with BPS and large pleural effusion were selected for laser coagulation in a single national reference center for fetal surgery. Feasibility, perinatal outcomes, complications, survival, respiratory morbidity, and need for neonatal lung mass resection are reported. RESULTS: 29 fetuses were treated at a median gestational age of 28.4 weeks. Hydrops was present in 13 (44.8%) cases. In 2 fetuses (6.9%), an intrathoracic bleeding was observed during fetal intervention, one presenting with intrauterine demise at 23 weeks of gestation. Median gestational age at birth was 38.9 weeks. Two fetuses (6.9%) were born preterm (33 and 35 weeks). Neonatal respiratory morbidity was reported in 3 neonates requiring oxygen support and in 2 neonates requiring mechanical ventilation. One fetus required postnatal thoracic surgery. There were no neonatal deaths; hence, the overall survival rate was 96.6% (28/29). CONCLUSIONS: Fetuses with BPS and large pleural effusion treated by laser coagulation of the feeding vessel have good perinatal outcomes and low risk of complications.