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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 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 offer evidence-based treatment strategies for hemangiomas and vascular malformations. They systematize care for improved patient outcomes in vascular anomalies.
Area of Science:
- Vascular Surgery
- Dermatology
- Pediatric Oncology
Background:
- Hemangiomas and vascular malformations require standardized treatment protocols.
- Current management strategies vary, necessitating evidence-based guidelines.
Purpose of the Study:
- To develop comprehensive clinical practice guidelines for managing vascular tumors, malformations, and related conditions.
- To optimize treatment efficacy, safety, and outcomes using evidence-based medicine.
Main Methods:
- Formulated clinical questions (CQs) based on critical clinical issues.
- Conducted systematic literature reviews of studies published from 1980-2020 in PubMed and JCRM.
- Assessed evidence strength and recommendations using the Minds technique.
Main Results:
- Addressed 38 CQs covering various treatment modalities including resection, sclerotherapy, embolization, drug therapy, laser, and radiotherapy.
- Considered treatment variations based on lesion location, symptoms, and timing.
- Included diagnostic criteria, pathological diagnosis, and genetic factors of vascular anomalies.
Conclusions:
- The Japanese Clinical Practice Guidelines for Vascular Tumors, Vascular Malformations, Lymphatic Malformations, and Lymphangiomatosis 2022 provide a systematic, evidence-based approach.
- These guidelines aim to standardize and improve the management of diverse vascular anomalies.
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