Risk factors for sequelae after surgery for lymphatic malformations in children

Area of Science:

• Pediatric Surgery
• Vascular Anomalies
• Medical Complications

Background:

• Lymphatic malformations (LMs) are congenital vascular anomalies requiring treatment.
• While pharmacological and interventional methods are first-line, surgery remains essential for select cases.
• Identifying factors predicting postoperative complications is crucial for patient management.

Purpose of the Study:

• To identify factors associated with permanent postoperative complications after surgical treatment of lymphatic malformations in children.
• To evaluate the impact of patient age, LM location, and malformation type on surgical outcomes.

Main Methods:

• A case series study comparing children with sequelae (cases) and without sequelae (controls) after LM surgery.
• Data collected from 112 children operated on for LMs between 2001 and 2021.
• Statistical analysis to determine factors associated with permanent complications.

Main Results:

• Patients younger than 1 year had significantly more complications (59%) compared to older children.
• Cervicofacial LMs and microcystic malformations were strongly associated with increased sequelae.
• Neurological complications, primarily peripheral facial palsy, were most common (88% of complications).

Conclusions:

• Surgical risk for lymphatic malformations is elevated in infants under 12 months, especially with cervicofacial and microcystic types.
• Non-radical resections showed fewer complications and comparable long-term cure rates.
• Aggressive surgical strategies should be judiciously applied to avoid guaranteed sequelae.