Percutaneous laser therapy for fetal tumours
Summary
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on percutaneous laser therapy for fetal tumours
Description
This guidance has considered the following types of fetal tumours: sacrococcygeal teratomas, cervical teratomas, cystic hygromas and congenital cystic adenomatoid malformations (CCAM). These tumours are usually benign, although teratomas may also be malignant. The tumours can become very large and highly vascularised, causing stress on the fetal heart, leading to the development of heart failure. Fetal mortality is high and a poor prognosis is associated with non-immune hydrops fetalis, placentomegaly, cardiomegaly, large tumour size and high tumour growth rate.
Percutaneous laser therapy for fetal tumours involves using laser energy to destroy tumour tissues and to coagulate blood vessels within the tumour. The procedure is performed under maternal local anaesthesia and light sedation by inserting a needle into the uterine cavity through the mother's abdomen under ultrasonographic guidance. An analgesic is then injected subcutaneously or intramuscularly into the fetus before advancing the needle to the site of the fetal tumour. Colour-Doppler imaging is used to guide placement of the needle. A laser fibre is passed through the needle lumen and laser energy is then delivered in pulses causing destruction of tumour tissues and coagulation of blood vessels within the tumour.
OPCS code:
R04.7 Percutaneous laser ablation of lesion of fetus
A code from categoryY95.- Gestational age must be assigned in a subsidiary position where this information is available.
Y53.2 Approach to organ under ultrasonic control
Code from Chapter Z to identify site of tumour
The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding
Details
Gynaecology, pregnancy and birth
Contact details:
(for general enquiries or comments)
(for procedure specific enquiries or comments)
ip@nice.org.uk
Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA
