Outcome of Injection Sclerotherapy With Doxycycline in Lymphatic, and Veno-lymphatic Malformation in Children: A Single Centre Experience.

IF 2.4 2区 医学 Q1 PEDIATRICS
Abhinav Sihag, Priya Ramachandran, Balagopal Subramaniam, Senthil Ganesh Kamaraj, Muhammed Jaseel
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Abstract

Aim: Lymphatic malformations (LMs) and Veno-lymphatic malformations (VLMs) are congenital slow flow vascular malformations. Intralesional sclerotherapy is a good alternate option for treatment of LMs and VLMs. Our aim was to evaluate the outcome of doxycycline sclerotherapy for lymphatic and veno-lymphatic malformation in children in our institute.

Methods: Retrospectively review of children with LMs or VLMs, primarily treated with doxycycline sclerotherapy in our hospital from January 2012 to December 2023. Patient's demographics, type and location of lesion, number of sclerotherapy sessions, final outcome and complications were recorded and data was analyzed. The clinical response was deemed excellent if lesion resolved completely (>90 % resolution) and satisfactory if there was >50 % resolution of lesion based on visual estimate. The response was considered as poor if <50 % resolution of lesion.

Results: Out of 70 patients, 34 (48 %) patients had lesion located in cervicofacial region. 164 sessions were required (range 1-7/patient). 47/70 (68 %) patients showed excellent response, 9/70 (12 %) patients showed satisfactory response and remaining 14/70 (20 %) patients showed poor response. 8 patients (11 %) required subsequent surgery after sclerotherapy. Sclerotherapy with doxycycline was successful in 80 % of patients. No major complication was noted in any patient.

Conclusion: Doxycycline sclerotherapy resulted in excellent clinical outcome and complete resolution of lesions in majority of cases without increased need for subsequent surgical resection. Doxycycline is a readily available and cost effective treatment option with minimum side effects. It should be considered as a primary treatment for LM and VLM in children.

注射硬化剂配合强力霉素治疗儿童淋巴管和静脉淋巴管畸形的效果:单中心经验。
目的:淋巴畸形(LMs)和静脉-淋巴畸形(VLMs)是先天性慢流血管畸形。局部硬化剂注射疗法是治疗淋巴畸形和静脉淋巴畸形的一种很好的替代疗法。我们的目的是评估多西环素硬化剂疗法治疗本院儿童淋巴管畸形和静脉淋巴管畸形的效果:回顾性分析 2012 年 1 月至 2023 年 12 月在我院接受强力霉素硬化疗法治疗的淋巴管畸形或静脉淋巴管畸形患儿。记录并分析患者的人口统计学特征、病变类型和位置、硬化剂治疗次数、最终疗效和并发症。如果病变完全消退(消退率大于 90%),则临床反应为极佳;如果目测病变消退率大于 50%,则临床反应为满意。结果在 70 名患者中,34 名(48%)患者的病灶位于颈面部。需要进行 164 次治疗(1-7 次/人)。47/70(68%)名患者的反应极佳,9/70(12%)名患者的反应令人满意,其余 14/70(20%)名患者的反应较差。8 名患者(11%)在硬化剂注射后需要进行后续手术。80%的患者使用强力霉素硬化剂治疗取得了成功。结论:多西环素硬化剂疗法在80%的患者中取得了成功,没有发现任何重大并发症:结论:多西环素硬化剂疗法的临床疗效极佳,大多数病例的病灶完全消退,无需进行后续手术切除。多西环素是一种现成的、经济有效的、副作用最小的治疗方法。应考虑将其作为儿童 LM 和 VLM 的主要治疗方法。
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来源期刊
CiteScore
1.10
自引率
12.50%
发文量
569
审稿时长
38 days
期刊介绍: The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.
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