AORN Journal
Volume 90, Issue 5 , Pages 661-676 , November 2009

The Ex Utero Intrapartum Treatment (EXIT) Procedure for Fetal Head and Neck Masses

  • Debora Filipchuk, RN, CPN(C)

      Affiliations

    • Debora Filipchuk, RN, CPN(C), is the clinical nurse educator in the pediatric OR at Stollery Children's Hospital, Edmonton, Alberta, Canada. Ms Filipchuk has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.
    • ,
  • Lourdes Avdimiretz, RN, CPN(C)

      Affiliations

    • Lourdes Avdimiretz, RN, CPN(C), is the ears, nose, and throat team leader in the pediatric OR at Stollery Children's Hospital, Edmonton, Alberta, Canada. Ms Avdimiretz has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.

References 

  1. Marwan A , Crombleholme TM . The EXIT procedure: principles, pitfalls, progress . Semin Pediatr Surg. . 2006;15(2):107–115
  2. MacKenzie TC , Crombleholme TM , Flake AW . The ex-utero intrapartum treatment . Curr Opin Pediatr. . 2002;14(4):453–458
  3. Chinnappa V , Halpern SH . The ex utero intrapartum treatment (EXIT) procedure: maternal and fetal considerations . Can J Anesthesia. . 2007;54(3):171–175
  4. Skarsard ED , Chitkara U , Krane EJ , Riley ET , Halamek LP , Dedo HH . The OOPS procedure (operation on placental support): in utero airway management of the fetus with prenatally diagnosed tracheal obstruction . J Pediatr Surg. . 1996;31(6):826–828
  5. Leichty KW , Crombleholme TM , Flake AW , et al.   Intrapartum airway management for giant fetal neck masses: the EXIT (ex utero intrapartum treatment) procedure . Am J Obstet Gynecol. . 1997;177(4):870–874
  6. Shih GH , Boyd GL , Vincent RD , Long GW , Hauth JC , Georgeson KE . The EXIT procedure facilitates delivery of an infant with a pretracheal teratoma . Anesthesiology . 1998;89(6):1573–1575
  7. Lymphatic malformations. Lymph Notes.com. http://lymphnotes.com/article.php/id/250. Accessed July 8, 2009.
  8. Lymphatic malformation  . Sick Kids . http://www.sickkids.ca/craniofacial/what-do-we/vascular-anomalies.vascular-malformations/lymphatic%20maleformations/index.html Accessed July 30, 2009.
  9. Giguere CM , Bauman NM , Smith RJ . New treatment options for lymphangioma in infants and children . Ann Otol Rhino Laryngol . 2002;111(12Pt1):1066–1075
  10. Lymphatic malformation  . University of Virginia Health System . http://www.healthsystem.virginia.edu/uvahealth/peds_ent/lymphmalform.cfm Accessed July 30, 2009.
  11. Rahbar R , Vogel A , Myers LB , et al.   Fetal surgery in otolaryngology: a new era in the diagnosis and management of fetal airway obstruction because of advances in prenatal imaging . Arch Otolaryngol Head Neck Surg. . 2005;131(5):393–398
  12. Howell LJ , Burns KM , Lenghetti E , Kerr JC , Harkins LS . Management of fetal airway obstruction: an innovative strategy . MCN Am J Matern Child Nurs. . 2002;27(4):238–243
  13. Rothrock JC . Patient and environmental safety . In:  Rothrock JC editors. Alexander's Care of the Patient in Surgery . 13th ed.. St Louis, MO: Mosby; 2007;p. 23–31
  14. Bray A . Preoperative nursing assessment of the surgical patient . Nurs Clin North Am. . 2006;41(2):135–150
  15. DeLamar LH . Anesthesia . In:  Rothrock JC editors. Alexander's Care of the Patient in Surgery . 13th ed.. St Louis, MO: Mosby; 2007;p. 111–114 125.
  16. Luzzatto C , Midrio P , Tchaprassian Z , Guglielmi M . Sclerosing treatment of lymphangiomas with OK-432 . Arch Dis Child . 2000;82(4):316–318
  17. OK-432 and the treatment of lymphatic malformations. National Organization of Vascular Anomalies . http//www.novanews.org/OK-432.htm Accessed July 26, 2009.
  18. Noah MM , Norton Me , Sandberg P , Esakoff T , Farrell J , Albanese CT . Short-term maternal outcomes that are associated with the EXIT procedure, as compared with cesarean delivery . Am J Obstet Gynecol. . 2002;186(4):773–777
  19. Stow J . Pediatric surgery . In:  Rothrock JC editors. Alexander's Care of the Patient in Surgery . 13th ed.. St Louis, MO: Mosby; 2007;p. 125
  20. Bouchard S , Johnson MP , Flake AW , et al.   The EXIT procedure: experience and outcome in 31 cases . J Pediatr Surg. . 2002;37(3):418–426

 Complete this CE activity online at aorn.org/CE indicates that continuing education contact hours are available for this activity. Earn the contact hours by reading this article and taking the examination on pages 673–674 and then completing the answer sheet and learner evaluation on pages 675–676. The contact hours for this article expire November 30, 2012.The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education. Ms Holm and Ms Bakewell have no declared affiliations that could be perceived as potential conflicts of interest in publishing this article.This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.AORN recognizes these activities as continuing education for registered nurses. This recognition does not imply that AORN or the American Nurses Credentialing Center approves or endorses products mentioned in the activity.AORN is provider-approved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure.

PII: S0001-2092(09)00410-4

doi: 10.1016/j.aorn.2009.06.001

AORN Journal
Volume 90, Issue 5 , Pages 661-676 , November 2009

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