Castañón M, Margarit J, Carrasco R, Vancells M, Albert A, Morales L
Department of Pediatric Surgery, Unidad Integrada Hospital Sant Joan de Déu, Universidad de Barcelona, Spain.
J Pediatr Surg. 1999 Aug;34(8):1276-9. doi: 10.1016/s0022-3468(99)90168-9.
Surgical exeresis is regarded as the first choice treatment for cystic lymphangioma. Surgery may be extremely complex, giving rise to complications. Several therapeutic methods have been described to avoid the complications derived from the conventional surgical approach. The idea of treating lymphangioma by means of suction and injection of fibrin sealant (Tissucol), is an alternative to surgery.
The authors present 19 cases of cystic lymphangioma, treated with fibrin sealant injected into the lesion, during the 1991 to 1997 period. Two of the patients had been treated surgically and experienced recurrence of the tumor previous to treatment. In the other 17 cases, puncture was the only therapy applied. One patient required 3 punctures, another 6 patients required 2 punctures, and only 1 of them, after 2 unsuccessful punctures, was treated with surgical resection. The rest of the 10 cases subsided after the first puncture. Follow-up ranged between 3 and 72 months, with a mean of 40 months.
The ultrasonographic (US) follow-up showed a complete remission in 17 patients treated with puncture. One patient remained with a small intermittent tumor, the appearance of which is related to catarrhal processes, and another patient rejected further puncture after the second one. No complications appeared.
These results support the fact that the puncture, aspiration, followed by injection of Tissucol, is a choice in the surgical treatment of cystic lymphangioma.
手术切除被视为囊性淋巴管瘤的首选治疗方法。手术可能极其复杂,并引发并发症。已经描述了几种治疗方法以避免传统手术方法产生的并发症。通过抽吸并注射纤维蛋白封闭剂(Tissucol)来治疗淋巴管瘤的方法是手术的一种替代方案。
作者报告了1991年至1997年期间用纤维蛋白封闭剂注入病变部位治疗的19例囊性淋巴管瘤病例。其中2例患者曾接受过手术治疗,在此次治疗前肿瘤复发。在其他17例病例中,穿刺是唯一采用的治疗方法。1例患者需要3次穿刺,另外6例患者需要2次穿刺,其中仅1例在2次穿刺失败后接受了手术切除。其余10例在首次穿刺后消退。随访时间为3至72个月,平均40个月。
超声(US)随访显示,17例接受穿刺治疗的患者完全缓解。1例患者仍有小的间歇性肿瘤,其出现与卡他性病变有关,另1例患者在第二次穿刺后拒绝进一步穿刺。未出现并发症。
这些结果支持以下事实,即穿刺、抽吸,然后注射Tissucol,是囊性淋巴管瘤手术治疗中的一种选择。