Long‐term outcome after fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia: systematic review
- 1GKT School of Medical Education, King's College London London UK
- 2Fetal Medicine Research Institute, King's College Hospital London UK
Abstract
Objective: This systematic review aimed to evaluate the long‐term outcomes of infants who had undergone fetal endoscopic tracheal occlusion (FETO) for congenital diaphragmatic hernia (CDH).
Methods: PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to October 2025 for studies reporting infant outcome ≥ 1 year post FETO in the following domains: growth and nutritional, neurodevelopmental, audiological, cardiac, respiratory, gastrointestinal and musculoskeletal. Quality was assessed using the revised Cochrane risk‐of‐bias tool for randomized trials and the Newcastle–Ottawa scale for cohort studies. Meta‐analysis was not performed due to outcome heterogeneity and a narrative synthesis was conducted instead.
Results: Fourteen studies (one randomized controlled trial and 13 cohort studies), including a total of 395 infants, were analyzed. The duration of follow‐up ranged from 7 to 87 months. Among domains of morbidity, respiratory complications were the most prevalent, although most improved over time. Growth failure affected a significant proportion of infants at 1 year, but considerable catch‐up growth was demonstrated by 2 years. Gastrointestinal morbidity was common, with gastroesophageal reflux disease reported in 25–50% of cases and hernia recurrence in 21–43%. Neurodevelopmental outcome was generally reassuring. Multiple studies found no significant differences in long‐term outcome between infants that underwent FETO and those that did not after adjusting for disease severity.
Conclusion: FETO‐treated CDH survivors experience substantial but improving multisystem morbidity that may be driven by factors independent of the intervention itself, emphasizing the need for long‐term multidisciplinary follow‐up. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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BibTeX
@article{shah2026longterm,
title = {{Long‐term outcome after fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia: systematic review}},
author = {S. Shah and R. Ruiz Roman and K. H. Nicolaides},
journal = {Ultrasound in Obstetrics \& Gynecology},
year = {2026},
month = aug,
doi = {10.1002/uog.70302},
url = {https://doi.org/10.1002/uog.70302},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Long‐term outcome after fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia: systematic review
AU - S. Shah
AU - R. Ruiz Roman
AU - K. H. Nicolaides
PY - 2026
DA - 2026/08/29
JO - Ultrasound in Obstetrics & Gynecology
DO - 10.1002/uog.70302
UR - https://doi.org/10.1002/uog.70302
AB - Objective: This systematic review aimed to evaluate the long‐term outcomes of infants who had undergone fetal endoscopic tracheal occlusion (FETO) for congenital diaphragmatic hernia (CDH). Methods: PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to October 2025 for studies reporting infant outcome ≥ 1 year post FETO in the following domains: growth and nutritional, neurodevelopmental, audiological, cardiac, respiratory, gastrointestinal and musculoskeletal. Quality was assessed using the revised Cochrane risk‐of‐bias tool for randomized trials and the Newcastle–Ottawa scale for cohort studies. Meta‐analysis was not performed due to outcome heterogeneity and a narrative synthesis was conducted instead. Results: Fourteen studies (one randomized controlled trial and 13 cohort studies), including a total of 395 infants, were analyzed. The duration of follow‐up ranged from 7 to 87 months. Among domains of morbidity, respiratory complications were the most prevalent, although most improved over time. Growth failure affected a significant proportion of infants at 1 year, but considerable catch‐up growth was demonstrated by 2 years. Gastrointestinal morbidity was common, with gastroesophageal reflux disease reported in 25–50% of cases and hernia recurrence in 21–43%. Neurodevelopmental outcome was generally reassuring. Multiple studies found no significant differences in long‐term outcome between infants that underwent FETO and those that did not after adjusting for disease severity. Conclusion: FETO‐treated CDH survivors experience substantial but improving multisystem morbidity that may be driven by factors independent of the intervention itself, emphasizing the need for long‐term multidisciplinary follow‐up. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
SN - 0960-7692
SN - 1469-0705
ER -