Han Tao, Ji Yi, Cui Jie, Shen Weimin
Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
Front Pediatr. 2021 Sep 22;9:749983. doi: 10.3389/fped.2021.749983. eCollection 2021.
The link between cystic lymphatic malformation (cLM) and normal lymphatic system has become the focus of research. This study aimed to assess the outcomes of indocyanine green (ICG) lymphography-guided inflow occlusion combined with bleomycin sclerotherapy for the management of macro or mixed cLM in children. Between June 2018 and October 2020, inflow occlusion combined with bleomycin sclerotherapy was performed in 81 cLM patients (age range from 6 months to 8 years). All cases were evaluated by the following parameters: cLM location, histological typing, number of afferent lymph vessels, dermal backflow, curative effects, treatment frequency, and postoperative complications. The duration of postoperative follow-up was from 10 to 16 months. All cLM cases could be found with at least one lymphatic inflow. Excellent outcomes were observed in 68 cases (84.0%), 11 cases (13.6%) experienced good outcomes, and two (2.5%) cases had fair outcome. No case experienced repeated treatment for more than three times. Wound infection, fever, and scar hyperplasia were the independent adverse events, which were managed by symptomatic treatment. Inflow occlusion combined with bleomycin sclerotherapy renders a safe and efficient approach for the management of macro or mixed cLM.
囊性淋巴管畸形（cLM）与正常淋巴系统之间的联系已成为研究焦点。本研究旨在评估吲哚菁绿（ICG）淋巴造影引导下的流入道闭塞联合博来霉素硬化治疗对儿童巨大型或混合型cLM的治疗效果。2018年6月至2020年10月，对81例cLM患者（年龄范围6个月至8岁）进行了流入道闭塞联合博来霉素硬化治疗。所有病例均通过以下参数进行评估：cLM位置、组织学类型、输入淋巴管数量、真皮回流、治疗效果、治疗频率及术后并发症。术后随访时间为10至16个月。所有cLM病例均能发现至少一条淋巴流入道。68例（84.0%）观察到极佳效果，11例（13.6%）效果良好，2例（2.5%）效果尚可。无病例接受超过三次的重复治疗。伤口感染、发热及瘢痕增生为独立不良事件，通过对症治疗处理。流入道闭塞联合博来霉素硬化治疗为巨大型或混合型cLM的治疗提供了一种安全有效的方法。
