Comparison of Solomon technique against selective laser ablation for XXXX : a systematic review.

@entity23 @entity417 @entity14244
OBJECTIVE: To perform a systematic review of studies comparing the Solomon versus selective techniques for fetoscopic laser ablation (FLA) to treat @entity14244 ( @entity14244 ) complicating monochorionic diamniotic twin pregnancies. METHODS: Electronic searches (inception-September 2014). Selected studies were of pregnancies undergoing FLA for @entity14244 with reports on any of; recurrence of @entity14244 , @entity417 ( @entity417 ) or survival. Three studies were included; two cohort studies and one @entity23 ( @entity23 ), which directly compared Solomon vs selective techniques for FLA. RESULTS: The odds ratios (OR) of recurrent @entity14244 , Solomon vs selective technique in the two cohort studies (n   =   249) were 0.30 (95% CI 0.00, 4.46) and 0.45 (95% CI 0.07, 2.20). The 'Solomon' @entity23 (n   =   274) demonstrated a statistically significant reduction in recurrent @entity14244 with the Solomon technique, OR 0.21 (95% CI 0.04, 0.98). The OR for the development of @entity417 following Solomon vs selective technique were 0.20 (95%CI 0.00, 2.46) and 0.61 (95%CI 0.05, 5.53) for the cohort studies and 0.16 (95% CI 0.05, 0.49) in the 'Solomon' @entity23 , again the results were only statistically significant in the @entity23 . The observational evidence suggested an overall better survival with Solomon technique, statistically significant for the survival of at least one twin. The @entity23 did not demonstrate a significant difference, probably due to small sample size and lack of power. CONCLUSION: This systematic review of observational, comparative cohort and @entity23 data suggests a trend towards a reduction in recurrent @entity14244 and @entity417 and an increase in twin survival with no increase in complications or adverse events. This needs to be confirmed by an appropriately powered @entity23 with long-term neurological follow-up.
