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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 City, 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 provide evidence-based recommendations for managing vascular anomalies like hemangiomas and malformations. They synthesize treatments, including surgery, sclerotherapy, and medication, to improve patient outcomes.
Area of Science:
- Vascular Surgery
- Dermatology
- Pediatric Oncology
Background:
- Hemangiomas and vascular malformations require systematic and evidence-based treatment approaches.
- Current management strategies can vary, necessitating standardized guidelines for optimal care.
Purpose of the Study:
- To establish comprehensive clinical practice guidelines for the management of vascular anomalies.
- To organize effective, safe, and efficient treatment strategies based on evidence-based medicine.
Main Methods:
- Formulated clinical questions (CQs) addressing key issues in vascular anomaly management.
- Conducted systematic literature reviews of studies published from 1980 to December 2020.
- Utilized the Medical Information Network Distribution Service (Minds) technique to assess evidence strength and recommendations.
Main Results:
- Addressed 38 CQs covering various treatment modalities: resection, sclerotherapy, embolization, drug therapy, laser therapy, radiotherapy, and conservative treatments.
- Considered factors influencing treatment choice, including lesion location, symptoms, and diagnostic criteria.
- Included information on pathological diagnosis and the genetic basis of vascular anomalies.
Conclusions:
- The Japanese clinical practice guidelines for vascular tumors, vascular malformations, lymphatic malformations, and lymphangiomatosis 2022 offer a systematic, evidence-based framework.
- These guidelines aim to improve the management and outcomes for patients with diverse vascular anomalies.
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