{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T21:16:02Z","timestamp":1788038162043,"version":"build-2784847793"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review aimed to evaluate the long\u2010term outcomes of infants who had undergone fetal endoscopic tracheal occlusion (FETO) for congenital diaphragmatic hernia (CDH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to October 2025 for studies reporting infant outcome \u2265\u20091\u2009year post FETO in the following domains: growth and nutritional, neurodevelopmental, audiological, cardiac, respiratory, gastrointestinal and musculoskeletal. Quality was assessed using the revised Cochrane risk\u2010of\u2010bias tool for randomized trials and the Newcastle\u2013Ottawa scale for cohort studies. Meta\u2010analysis was not performed due to outcome heterogeneity and a narrative synthesis was conducted instead.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fourteen studies (one randomized controlled trial and 13 cohort studies), including a total of 395 infants, were analyzed. The duration of follow\u2010up ranged from 7 to 87\u2009months. 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\u2009year, but considerable catch\u2010up growth was demonstrated by 2\u2009years. Gastrointestinal morbidity was common, with gastroesophageal reflux disease reported in 25\u201350% of cases and hernia recurrence in 21\u201343%. Neurodevelopmental outcome was generally reassuring. Multiple studies found no significant differences in long\u2010term outcome between infants that underwent FETO and those that did not after adjusting for disease severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      FETO\u2010treated CDH survivors experience substantial but improving multisystem morbidity that may be driven by factors independent of the intervention itself, emphasizing the need for long\u2010term multidisciplinary follow\u2010up. \u00a9 2026 The Author(s).\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.70302","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T20:34:23Z","timestamp":1788035663000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term outcome after fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia: systematic review"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6676-8920","authenticated-orcid":false,"given":"S.","family":"Shah","sequence":"first","affiliation":[{"name":"GKT School of Medical Education, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5866-8711","authenticated-orcid":false,"given":"R.","family":"Ruiz Roman","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-0711","authenticated-orcid":false,"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,29]]},"reference":[{"issue":"5","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1007\/s00247-009-1437-9","article-title":"Tracheomegaly: a complication of fetal endoscopic tracheal occlusion in the treatment of congenital diaphragmatic hernia","volume":"40","author":"McHugh K","year":"2010","journal-title":"Pediatr Radiol"},{"issue":"5","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.21037\/tp-20-130","article-title":"Fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia: a narrative review of the history, current practice, and future directions","volume":"10","author":"Perrone EE","year":"2021","journal-title":"Transl Pediatr"},{"issue":"2","key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/uog.1711","article-title":"Fetoscopic tracheal occlusion (FETO) for severe congenital diaphragmatic hernia: evolution of a technique and preliminary results","volume":"24","author":"Deprest J","year":"2004","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"4","key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.jpedsurg.2018.04.008","article-title":"Prenatally versus postnatally diagnosed congenital diaphragmatic hernia\u00a0\u2013\u00a0Side, stage, and outcome","volume":"54","author":"Burgos CM","year":"2019","journal-title":"J Pediatr Surg"},{"issue":"2","key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1056\/NEJMoa2027030","article-title":"Randomized trial of fetal surgery for severe left diaphragmatic hernia","volume":"385","author":"Deprest JA","year":"2021","journal-title":"N Engl J Med"},{"issue":"2","key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1056\/NEJMoa2026983","article-title":"Randomized trial of fetal surgery for moderate left diaphragmatic hernia","volume":"385","author":"Deprest JA","year":"2021","journal-title":"N Engl J Med"},{"issue":"2","key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1002\/pd.5849","article-title":"The TOTAL trial dilemma: a survey among professionals on equipoise regarding fetal therapy for severe congenital diaphragmatic hernia","volume":"41","author":"Vergote S","year":"2021","journal-title":"Prenat Diagn"},{"key":"e_1_2_7_9_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","journal-title":"BMJ"},{"issue":"3","key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.jaapos.2017.10.013","article-title":"Ocular injury during fetal endoscopy surgery","volume":"22","author":"Flores\u2010Pimentel M","year":"2018","journal-title":"J Am Assoc Pediatr Ophthalmol Strabismus (JAAPOS)"},{"issue":"3","key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1067\/mob.2001.117344","article-title":"Fetoscopic temporary tracheal occlusion by means of detachable balloon for congenital diaphragmatic hernia","volume":"185","author":"Harrison MR","year":"2001","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_12_1","volume-title":"Health Disparities in Quality Indicators of Healthcare Among Adults with Mental Illness [Internet]","author":"Gierisch JM","year":"2014"},{"issue":"1","key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jpedsurg.2004.09.037","article-title":"Survival of severe congenital diaphragmatic hernia has morbid consequences","volume":"40","author":"Cortes RA","year":"2005","journal-title":"J Pediatr Surg"},{"issue":"9","key":"e_1_2_7_14_1","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1016\/j.jpedsurg.2013.01.049","article-title":"Outcome of CDH infants following fetoscopic tracheal occlusion \u2014 influence of premature delivery","volume":"48","author":"Ali K","year":"2013","journal-title":"J Pediatr Surg"},{"issue":"1","key":"e_1_2_7_15_1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jpedsurg.2022.09.042","article-title":"Morbidity in children after fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia: Results from a multidisciplinary clinic","volume":"58","author":"Sferra SR","year":"2023","journal-title":"J Pediatr Surg"},{"issue":"7","key":"e_1_2_7_16_1","doi-asserted-by":"crossref","first-page":"3243","DOI":"10.1007\/s00431-023-04977-3","article-title":"Do FETO CDH survivors need the same follow\u2010up program as non\u2010FETO patients?","volume":"182","author":"Pertierra Cortada A","year":"2023","journal-title":"Eur J Pediatr"},{"issue":"7","key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1016\/j.jpedsurg.2024.03.041","article-title":"Neurodevelopmental outcomes in children after fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia: results from a multidisciplinary clinic","volume":"59","author":"Sferra SR","year":"2024","journal-title":"J Pediatr Surg"},{"issue":"5","key":"e_1_2_7_18_1","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1159\/000491785","article-title":"Tracheal diameter and respiratory outcome in infants with congenital diaphragmatic hernia treated by fetal endoscopic tracheal occlusion","volume":"46","author":"Morandi A","year":"2018","journal-title":"Fetal Diagn Ther"},{"issue":"6","key":"e_1_2_7_19_1","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1002\/uog.20216","article-title":"Fetal endoscopic tracheal occlusion reduces pulmonary hypertension in severe congenital diaphragmatic hernia","volume":"54","author":"Style CC","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"2","key":"e_1_2_7_20_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajogmf.2023.101248","article-title":"Fetoscopic endoluminal tracheal occlusion vs expectant management for fetuses with severe left\u2010sided congenital diaphragmatic hernia","volume":"6","author":"D\u00fctemeyer V","year":"2024","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"7","key":"e_1_2_7_21_1","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/S0022-3468(03)00182-9","article-title":"Fetoscopic temporary tracheal occlusion for congenital diaphragmatic hernia: prelude to a randomized, controlled trial","volume":"38","author":"Harrison MR","year":"2003","journal-title":"J Pediatr Surg"},{"issue":"7","key":"e_1_2_7_22_1","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1007\/s00383-019-04484-3","article-title":"Outcomes of infants with congenital diaphragmatic hernia by side of defect in the FETO era","volume":"35","author":"Ali K","year":"2019","journal-title":"Pediatr Surg Int"},{"issue":"6","key":"e_1_2_7_23_1","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/j.jpeds.2014.02.023","article-title":"Tracheomegaly in infants with severe congenital diaphragmatic hernia treated with fetal endoluminal tracheal occlusion","volume":"164","author":"Zani A","year":"2014","journal-title":"J Pediatr"},{"issue":"2","key":"e_1_2_7_24_1","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1053\/j.semperi.2005.04.006","article-title":"Fetal intervention for congenital diaphragmatic hernia: the European experience","volume":"29","author":"Deprest J","year":"2005","journal-title":"Semin Perinatol"},{"issue":"1","key":"e_1_2_7_25_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/AOG.0000000000001749","article-title":"Feasibility and outcomes of fetoscopic tracheal occlusion for severe left diaphragmatic hernia","volume":"129","author":"Belfort MA","year":"2017","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_26_1","doi-asserted-by":"crossref","first-page":"467","DOI":"10.3389\/fped.2020.00467","article-title":"Is Fetal Endoscopic Tracheal Occlusion (FETO) a predisposing factor for acid gastro\u2010esophageal reflux in infants with congenital diaphragmatic hernia?","volume":"8","author":"Macchini F","year":"2020","journal-title":"Front Pediatr"},{"issue":"12","key":"e_1_2_7_27_1","doi-asserted-by":"crossref","first-page":"3572","DOI":"10.3390\/jcm13123572","article-title":"Fetoscopic tracheal occlusion for isolated severe left diaphragmatic hernia: a systematic review and meta\u2010analysis","volume":"13","author":"Provinciatto H","year":"2024","journal-title":"J Clin Med"},{"issue":"9","key":"e_1_2_7_28_1","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1007\/s00383-022-05170-7","article-title":"Fetal endoscopic tracheal occlusion for moderate and severe congenital diaphragmatic hernia: a systematic review and meta\u2010analysis of randomized controlled trials","volume":"38","author":"Li Q","year":"2022","journal-title":"Pediatr Surg Int"},{"issue":"6","key":"e_1_2_7_29_1","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1002\/uog.26164","article-title":"Fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia: systematic review and meta\u2010analysis","volume":"61","author":"Chen Y","year":"2023","journal-title":"Ultrasound Obstet Gynecol"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.70302","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.70302","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.70302","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T20:34:33Z","timestamp":1788035673000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.70302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,29]]},"references-count":28,"alternative-id":["10.1002\/uog.70302"],"URL":"https:\/\/doi.org\/10.1002\/uog.70302","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,29]]},"assertion":[{"value":"2026-03-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"uog.70302"}}