Department of Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, Taiwan.
Ann Plast Surg. 2020 Mar;84(3):288-292. doi: 10.1097/SAP.0000000000002049.
Lymphatic malformations remain a challenge for patients and plastic surgeons. Promising results have been reported using intralesional laser photocoagulation (ILP) for treating vascular anomalies.
The objective of our study is to review the long-term results of a large series of lymphatic malformations in patients treated with ILP.
A retrospective review of 190 head and neck lymphatic malformations in patients were treated by ILP with an neodymium-yttrium-aluminum-garnet (Nd:YAG) laser (1064 nm) over a period of 20 years (January 1997-January 2016). Patients' ages ranged from 10 months to 12 years and 6 months (mean, 1 year and 11 months). The patient group consisted of 98 female and 92 male patients.
Patients were treated with an Nd:YAG laser (Sharplan Inc, Allendale, New Jersey) delivered through a 600-μm optical fiber. Laser power was set at 7 to 15 W and delivered with a pulse duration of 7 to 15 seconds. All patients demonstrated improvement as judged by clinical assessment of the reduction in lesion size (range, 65%-100%; mean reduction, 85%). One hundred fifty-two (80%) patients had a more than 65% reduction of the volume in lymphatic malformations at 3 months after 1 treatment, and 171 (90%) patients had a more than 85% reduction of the volume after 2 treatments. Excellent results were seen in 19 (10%) patients after 3 treatments. Postoperative complications were related to photocoagulation that was delivered too extensively or superficially, with resultant ulceration, infection, induration, and scarring.
Throughout the course of our long-term study, ILP using an Nd:YAG laser is an effective treatment modality for lymphatic malformations. Complications can be avoided if the potential for harm is kept in mind.
淋巴管畸形仍然是患者和整形外科医生面临的挑战。使用腔内激光光凝（ILP）治疗血管畸形已取得可喜的效果。
我们研究的目的是回顾用 ILP 治疗的大量淋巴管畸形患者的长期结果。
对 190 例头颈部淋巴管畸形患者进行回顾性分析，这些患者在 20 年期间（1997 年 1 月至 2016 年 1 月）接受了腔内激光光凝治疗，使用钕钇铝石榴石（Nd：YAG）激光（1064nm）。患者年龄为 10 个月至 12 岁零 6 个月（平均 1 岁 11 个月）。患者组包括 98 名女性和 92 名男性。
患者接受 Nd：YAG 激光（Sharplan Inc，新泽西州艾伦代尔）治疗，通过 600μm 光纤传输。激光功率设置为 7 至 15W，脉冲持续时间为 7 至 15 秒。所有患者均根据病变大小减少的临床评估（范围为 65％-100％；平均减少 85％）判断有所改善。在 1 次治疗后 3 个月，152 例（80％）患者淋巴管畸形体积减少超过 65％，171 例（90％）患者体积减少超过 85％。在 3 次治疗后，19 例（10％）患者获得了极好的效果。术后并发症与光凝过度或过浅有关，导致溃疡、感染、硬结和瘢痕形成。
在我们的长期研究过程中，Nd：YAG 激光腔内激光光凝是治疗淋巴管畸形的有效方法。如果能牢记潜在的危害，就能避免并发症。
