Kim So Young, Lee Sanghoon, Seo Jeong-Meen, Lim So Young
Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of General Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Int J Pediatr Otorhinolaryngol. 2015 Apr;79(4):570-5. doi: 10.1016/j.ijporl.2015.01.030. Epub 2015 Feb 7.
Surgical treatment of extensive cervicofacial lymphatic malformations is often challenging due to a high rate of postoperative fluid re-accumulation and lesion recurrence resulting from incomplete resection. This study suggests a combined treatment of surgical resection and postoperative adjuvant OK-432 sclerotherapy via closed suction drainage. Using comparative analysis, this study aims to evaluate the efficacy of adjuvant sclerotherapy.
A retrospective chart review was performed on patients who underwent surgical resection of cervicofacial lymphatic malformations between January 2009 and July 2013. Patients were divided into two groups based on whether or not adjuvant OK-432 sclerotherapy was administered via closed suction drainage after surgery. Both surgery-related and adjuvant sclerotherapy-related complications were assessed, and treatment effectiveness was measured based on the change in Cologne Disease Score (CDS) or the need for further treatment.
A total of 17 patients underwent surgical resection. Nine of these patients underwent surgical resection only, while the other eight underwent surgical resection with adjuvant OK-432 sclerotherapy. The increase in total Cologne Disease Score (CDS) and change of progression parameters were significantly higher for the adjuvant sclerotherapy group compared to the surgery-only group. Additionally, there were no cases of postoperative lymphatic fluid retention among the adjuvant sclerotherapy group. The two groups exhibited similar complication rates with no statistically significant difference.
Adjuvant OK-432 sclerotherapy via closed suction drainage is a safe and effective treatment modality. The combination of surgical resection and post-operative adjuvant sclerotherapy via closed suction drainage should be integrated into the treatment algorithm of extensive cervicofacial lymphatic malformation.
广泛的头颈部淋巴管畸形的手术治疗往往具有挑战性，因为术后液体重新积聚和不完全切除导致病变复发的发生率很高。本研究提出了一种手术切除与术后通过闭式吸引引流辅助使用OK-432硬化疗法的联合治疗方法。本研究旨在通过比较分析评估辅助硬化疗法的疗效。
对2009年1月至2013年7月期间接受头颈部淋巴管畸形手术切除的患者进行回顾性病历审查。根据术后是否通过闭式吸引引流给予辅助OK-432硬化疗法将患者分为两组。评估与手术相关和与辅助硬化疗法相关的并发症，并根据科隆疾病评分（CDS）的变化或进一步治疗的需求来衡量治疗效果。
共有17例患者接受了手术切除。其中9例患者仅接受了手术切除，而其他8例接受了手术切除并辅助使用OK-432硬化疗法。与仅手术组相比，辅助硬化疗法组的总科隆疾病评分（CDS）增加和进展参数变化明显更高。此外，辅助硬化疗法组没有术后淋巴液潴留的病例。两组的并发症发生率相似，无统计学显著差异。
通过闭式吸引引流进行辅助OK-432硬化疗法是一种安全有效的治疗方式。手术切除与术后通过闭式吸引引流进行辅助硬化疗法的联合应纳入广泛头颈部淋巴管畸形的治疗方案中。
