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Treatment of lymphangioma in children: our experience of 128 cases.
- Source :
-
Journal of pediatric surgery [J Pediatr Surg] 2007 Feb; Vol. 42 (2), pp. 386-9. - Publication Year :
- 2007
-
Abstract
- Purpose: The aim of this study is to investigate the optimal treatment for lymphangioma in children by analyzing the effectiveness and complications of treatment modalities.<br />Methods: We reviewed 128 patients with lymphangioma treated at our institution between 1979 and 2005. Periods of treatment were divided arbitrarily into 2 groups: period I, from 1979 to 1988 (n = 53); and period II, from 1989 to 2005 (n = 75). According to radiological appearance, patients were grouped into 4 types: single cystic (SI; n = 23), macrocystic (MA; n = 11), microcystic (MI; n = 69), and cavernous (CA; n = 25).<br />Results: Sclerotherapy as primary treatment was performed in only 2 patients (3.8%) in period I using bleomycin but increased significantly in period II to 48 patients (64.0%) using OK-432 (P < .01). Nevertheless, primary surgical excision (69/78 patients, 88.5%) was significantly more successful than sclerotherapy (32/50, 64.0%) (P < .01). The following are the locations and types of lesions: head/neck (n = 69; SI, 11; MA, 5; MI, 42; CA, 11), trunk (n = 34; SI, 6; MA, 6; MI, 15; CA, 7), and extremities/other (n = 25; SI, 6; MI, 12; CA, 7). The effectiveness of sclerotherapy in SI, MA, MI, and CA types was 90.9%, 100%, 68.0%, and 10.0%, respectively. Seventeen patients (SI, 1; MI, 8; CA, 8) who received primary sclerotherapy required surgical excision with good outcome. Complications after primary surgical excision were more serious compared with sclerotherapy.<br />Conclusion: Sclerotherapy with OK-432 was not as effective as reported in the literature. We recommend OK-432 injection therapy alone for SI and MA types and surgical excision after pretreatment with OK-432 for MI and CA types.
- Subjects :
- Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Head and Neck Neoplasms diagnosis
Head and Neck Neoplasms mortality
Head and Neck Neoplasms therapy
Humans
Infant
Lymphangioma diagnosis
Lymphangioma mortality
Male
Mediastinal Neoplasms diagnosis
Mediastinal Neoplasms mortality
Mediastinal Neoplasms therapy
Probability
Retrospective Studies
Risk Assessment
Sclerosing Solutions therapeutic use
Survival Rate
Treatment Outcome
Lymphangioma therapy
Picibanil therapeutic use
Sclerotherapy methods
Surgical Procedures, Operative methods
Subjects
Details
- Language :
- English
- ISSN :
- 1531-5037
- Volume :
- 42
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of pediatric surgery
- Publication Type :
- Academic Journal
- Accession number :
- 17270554
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2006.10.012