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Comparison of different therapeutic approaches for children with common lymphatic malformation
G Anggreyni1, N Agustriani1, N Agustriani2
1Universitas Gadjah Mada, Public Health and Nursing, Faculty of Medicine, Department of Surgery, Pediatric Surgery Division, Yogyakarta, Indonesia.
Insights
Surgery, bleomycin sclerotherapy, and combination therapy showed no significant differences in treating pediatric lymphatic malformations (LM). While each method had unique benefits, further research is needed to confirm these findings in larger patient groups.
Area of Science:
- Pediatric Surgery
- Dermatology
- Vascular Anomalies
Background:
- Lymphatic malformation (LM) is a common condition in children.
- Treatment options for LM include surgery, bleomycin sclerotherapy, and combination therapy.
- Assessing treatment outcomes requires standardized scoring systems.
Purpose of the Study:
- To compare the effectiveness of surgery, bleomycin sclerotherapy, and combination therapy for pediatric lymphatic malformations.
- To evaluate outcomes based on size reduction, aesthetics, function, complications, and intervention frequency.
Main Methods:
- Retrospective review of 31 pediatric LM patients treated between January 2015 and January 2019.
- Patients were divided into three groups: surgery (I), bleomycin sclerotherapy (II), and combination (III).
- Outcomes were assessed using scoring systems for size, aesthetics, function, complications, and intervention needs.
Main Results:
- No significant overall difference in total scores among the three treatment groups (p=0.056).
- Bleomycin sclerotherapy showed better aesthetic outcomes (p=0.001).
- Combination therapy required more further interventions (p=0.026), while surgery had higher intervention frequencies (p<0.001). No significant differences in size reduction, function, or complications.
Conclusions:
- No single treatment modality for pediatric LM demonstrated a significantly superior overall effect.
- Specific parameters like aesthetics or intervention needs varied between treatments.
- Larger, multicenter, prospective studies are recommended to validate these findings.
Background:
Our study compared the outcomes of three different therapies: surgery (Group I), bleomycin sclerotherapy (Group II), and a combination of both (Group III), for children with common (cystic) lymphatic malformation (LM) at a paediatric surgical centre in Yogyakarta, Indonesia.
Methods:
Medical records of patients who were treated for LM in the Paediatric Surgical Centre Universitas Gadjah Mada from January 2015 to January 2019 were reviewed. Scoring systems were used to assess the outcomes, including reduction of size, problems of aesthetics, functional problems, complications, necessity of further interventions, and interventions' frequencies.
Results:
During the four-year study, we included 31 children, consisting of 6, 5, and 20 patients in Groups I, II, and III, respectively. The total score did not significantly differ between Groups I, II, and III (14.67±2.80 vs. 13.40±2.07 vs. 12.50±1.47, respectively; p=0.056). Group II scored better in aesthetic problems than other groups (p=0.001), Group III scored higher in necessity of further interventions compared to the other groups (p=0.026), and Group I was higher in interventions' frequencies than the other groups (p<0.001). However, there were no significant differences in reduction of size, functional problems, and complications among groups (p=0.554, 0.151, and 0.076, respectively).
Conclusions:
There is no significant different effect of the three modalities treatment for LM, although one group might have more beneficial effects compared with the other groups due to different scoring system parameters. Further multicentre and prospective cohort studies with a larger number of patients are necessary to establish the existence and extent of our findings.
