2005 Fiscal Year Final Research Report Summary
Endoscopic tracheal balloon occlusion in congenital diaphragmatic hernia sheep model
| Project/Area Number |
14571707
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Pediatric surgery
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| Research Institution | Nihon University |
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Principal Investigator |
KOSHINAGA Tsugumichi Nihon University, School of Medicine, Associate Professor, 医学部, 助教授 (70205376)
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| Co-Investigator(Kenkyū-buntansha) |
TAKAGI Kenjiro Nihon University, School of Medicine, Assistant Professor, 医学部, 講師 (00216623)
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| Project Period (FY) |
2002 – 2005
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| Keywords | congenital diaphragmatic hernia / pregnant sheep / pregnant guinea pig / pregnant rat / endoscopic tracheal occlusion |
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| Research Abstract |
Aim : We aimed to produce animal model with left congenital diaphragmatic hernia and performed endoscopic tracheal occlusion treatment. We also discussed the clinical application for human fetal treatment in Japan.
Methods : 1.Left diaphragmatic hernia production 2.Endotracheal occlusion by detachable balloon
Results :
1. Basic operative technique for diaphragmatic hernia in small animal. Guinea pigs at 40 days of gestation were used for left diaphragmatic hernia production. Also rats were used as a liver herniation model produced by nitrofen.
2 Endoscopic apparatus. We performed endoscopic tracheal occlusion by detachable balloon on three sheep at 90days of gestation. One fetus of three died intrauterine due to premature detachment of the placenta. The rest underwent successfully Caesarean section.
3. Left diaphragmatic hernia production in sheep. We produced surgically left diaphragmatic hernia in sheep at 75 days of gestation.
4. A randomized trial of human fetal endoscopic tracheal occlusion performed by Harrison MR. et al. at UCSF. Eight of 11fetuses (73 percent) in the tracheal-occlusion group and 10 of 13 (77 percent) in the group that received standard care survived to 90 days of age (P=1.00). The tracheal occlusion did not improve survive or morbidity rates in he cohort of fetuses with congenital diaphragmatic hernia.
These results do not give any supporting evidences to apply this treatment for human fetuses with congenital diaphragmatic hernia also in Japan. Severe congenital diaphragmatic hernias of Lung to head ratio (LHR) less than 0.9 must be a future issue to solve.
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