Xiong Yang, Yang Liu, Zhen Wang, Fangyong Dong, Feng Wan, Ting Lei
Department of Neurosurgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Hankou, Wuhan, 430030, People's Republic of China.
Neurosurg Rev. 2018 Jul;41(3):737-743. doi: 10.1007/s10143-016-0796-6. Epub 2016 Oct 28.
The aim of this study is to compare the outcomes of surgical and conservative treatments of pediatric asymptomatic lumbosacral lipomas, and to address whether the patients can benefit from prophylactic surgeries. The literature reports of surgical and conservative treatments of child asymptomatic lumbosacral lipomas were reviewed and collected, and a meta-analysis of the reports regarding the incidence of sphincter and lower limb dysfunctions was performed. A total of five literatures were collected, containing a total of 403 patients, among which 124 patients received conservative treatments with 32 (25.81%) cases developing neurological dysfunctions during follow-up, and 279 received prophylactic surgical treatments with 30 (10.75%) patients developing neurological dysfunctions in follow-up, the difference being statistically significant (P ≤ 0.05). For pediatric asymptomatic lumbosacral lipomas of the three major subtypes, the limited source of literature so far suggests that prophylactic surgery is superior to conservative strategy in preventing the patients from neurological deterioration. Larger patient cohorts, randomized studies, and longer length of follow-ups are needed for further corroboration.
本研究旨在比较小儿无症状腰骶部脂肪瘤手术治疗与保守治疗的效果，并探讨患者是否能从预防性手术中获益。回顾并收集了关于小儿无症状腰骶部脂肪瘤手术及保守治疗的文献报道，并对括约肌和下肢功能障碍发生率的报道进行了荟萃分析。共收集到5篇文献，包含403例患者，其中124例接受保守治疗，随访期间32例（25.81%）出现神经功能障碍；279例接受预防性手术治疗，随访期间30例（10.75%）出现神经功能障碍，差异有统计学意义（P≤0.05）。对于三种主要亚型的小儿无症状腰骶部脂肪瘤，目前有限的文献资料表明，预防性手术在预防患者神经功能恶化方面优于保守策略。需要更大的患者队列、随机研究以及更长的随访时间来进一步证实。
