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25 years' experience with lymphangiomas in children
A Alqahtani1, L T Nguyen, H Flageole
1The Montreal Children's Hospital, Department of Surgery, McGill University, Quebec, Canada.
Journal of Pediatric Surgery
|August 12, 1999
Summary
Complete surgical excision is key to managing pediatric lymphangioma, as nonoperative treatments like aspiration and injection lead to high recurrence rates. Recurrence risk factors include lesion location, size, and complexity.
Area of Science:
- Pediatric Surgery
- Vascular Anomalies
- Oncology
Background:
- Lymphangioma management in children presents challenges due to difficulties in achieving complete resection and high recurrence rates.
- Understanding risk factors for recurrence and evaluating nonoperative treatment efficacy is crucial for optimizing patient outcomes.
Purpose of the Study:
- To review a 25-year experience with pediatric lymphangioma.
- To identify risk factors associated with lymphangioma recurrence.
- To assess the role and effectiveness of nonoperative treatment modalities.
Main Methods:
- Retrospective analysis of 186 pediatric patients (191 lesions) treated over 25 years.
- Data collected on patient demographics, lesion characteristics (size, location), and treatment modalities.
- Treatments included complete excision, partial excision, aspiration, laser excision, and injection of sclerosing agents.
Main Results:
- Macroscopically complete excision resulted in the lowest recurrence rate (17%), while aspiration and injection showed 100% recurrence.
- Recurrence rates varied by location: highest in the head (33%), lowest in internal locations (0%).
- No significant difference in outcome was observed between immediate and delayed surgical intervention.
Conclusions:
- Macroscopically complete excision is associated with significantly fewer recurrences compared to other treatments.
- Lesion location, size, and complexity are significant risk factors for recurrence.
- Observation may be beneficial for infants to facilitate complete excision; spontaneous regression is rare.