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Published on: June 15, 2020
Japanese clinical practice guidelines for vascular tumors, vascular malformations, lymphatic malformations, and
Yoshiaki Kinoshita1, Kosuke Ishikawa2, Sadanori Akita3,4
1Department of Pediatric Surgery, Niigata University, Niigata, Japan.
Abstract:
The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety, and systematizing treatment, employing evidence-based medicine techniques and aimed at improvement of the outcomes. Clinical questions (CQs) were decided based on the important clinical issues. For document retrieval, key words for literature searches were set for each CQ and literature published from 1980 to the end of December 2020 was searched in PubMed and Japana Centra Revuo Medicina (JCRM). The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution Service (Minds) technique. A total of 38 CQs were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy, and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, pathological diagnosis deciding the diagnosis, and causal genes of vascular anomalies. Thus, the Japanese Clinical Practice Guidelines for Vascular Tumors, Vascular Malformations, Lymphatic Malformations, and Lymphangiomatosis 2022 have been prepared as the evidence-based guidelines for the management of vascular anomalies.
Insights
These guidelines offer evidence-based recommendations for managing vascular anomalies like hemangiomas and malformations. They systematize treatments for improved patient outcomes, ensuring safety and efficacy.
Area of Science:
- Vascular Surgery
- Dermatology
- Pediatric Oncology
Background:
- Hemangiomas and vascular malformations require standardized, evidence-based treatment protocols.
- Current management strategies vary, necessitating updated clinical practice guidelines.
Purpose of the Study:
- To develop comprehensive clinical practice guidelines for the management of vascular tumors, vascular malformations, lymphatic malformations, and lymphangiomatosis.
- To organize effective, efficient, and safe treatment strategies based on evidence-based medicine.
Main Methods:
- Systematic literature review of publications from 1980 to December 2020 in PubMed and JCRM.
- Formulation of clinical questions (CQs) addressing key management issues.
- Assessment of evidence strength and recommendations using the Medical Information Network Distribution Service (Minds) technique.
Main Results:
- 38 clinical questions were addressed to compile recommendations.
- Guideline topics include efficacy of various treatments (resection, sclerotherapy, embolization, drug therapy, laser, radiotherapy, conservative), treatment variations by lesion location and symptoms, optimal timing, diagnostic pathology, and genetic factors.
- The guidelines cover hemangiomas, vascular malformations, lymphatic malformations, and lymphangiomatosis.
Conclusions:
- The Japanese Clinical Practice Guidelines for Vascular Tumors, Vascular Malformations, Lymphatic Malformations, and Lymphangiomatosis 2022 provide evidence-based recommendations for managing vascular anomalies.
- These guidelines aim to improve treatment outcomes through systematized, safe, and effective approaches.
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