[Indications for primary surgical therapy of vascular abnormalities in infancy]

LASER THERAPY: Since the introduction of laser therapy for treatment of hemangiomas and vascular malformations, primary surgical therapy has gradually lost importance. Particularly hemangiomas, but also venous malformations and lymphangiomas, are nowadays primarily treated by different types of lasers. Especially the Nd:YAG laser with a percutaneous or transcutaneous application technique often leads to satisfying results.

Surgical therapy is mostly used secondarily in late childhood or in adults after several laser applications for excision of residual scars or other corrective procedures. Despite these improvements in laser therapy, there is still an indication for primary surgical treatment in subcutaneous vascular malformations and in rapidly growing hemangiomas after unsuccessful laser therapy. Even in large vascular anomalies, safe excision with only a little blood loss is possible if the tumors are encapsulated.

In this paper we want to point out the necessity of primary surgery in three children in whom complications such as loss of sight, facial nerve palsy, and a lethal outcome due to massive hemorrhage in a cystic lymphangioma could be avoided.