Choi Jun Ho, Choi Seung Yeon, Hwang Jae Ha, Kim Kwang Seog, Lee Sam Yong
Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
Arch Craniofac Surg. 2023 Feb;24(1):10-17. doi: 10.7181/acfs.2023.00017. Epub 2023 Feb 20.
Lipomas are common benign tumors of mesenchymal origin that are composed of mature adipocytes. Giant lipomas have a diameter ≥ 10 cm in one or more dimensions or weigh at least 1,000 g. The surgical excision of a giant lipoma requires extensive dissection, increasing the risk of a seroma, which can cause surgical site complications such as wound infection and necrosis. Sclerotherapy with Abnobaviscum (Viscum album extract) is a relatively new technique used to reduce malignant pleural effusion. In this study, we evaluated the effectiveness of prophylactic sclerotherapy using Abnobaviscum to decrease seroma after giant lipoma excision.
We conducted a retrospective medical record review of patients who underwent surgical excision for giant lipoma of the neck from January 2019 to December 2022. Sclerotherapy was performed on the first postoperative day in patients who consented to the procedure, and Abnobaviscum was instilled through the existing Hemovac drain. We compared the clinical course between those who underwent postoperative sclerotherapy and those who did not.
Among the 30 patients who underwent giant lipoma excision, we applied sclerotherapy with Abnobaviscum to 15 patients. The average time from surgery to Hemovac removal was statistically shorter in patients who underwent sclerotherapy (p= 0.004). Furthermore, seroma formation was significantly reduced in patients receiving sclerotherapy (p= 0.003).
In patients undergoing giant lipoma excision, sclerotherapy using Abnobaviscum helps reduce postoperative seroma formation during the initial postoperative period. It can be an excellent method to reduce complications related to seroma and attenuate patients' postoperative burden.
脂肪瘤是常见的间叶组织起源的良性肿瘤，由成熟脂肪细胞组成。巨大脂肪瘤在一个或多个维度上直径≥10 cm或重量至少为1000 g。巨大脂肪瘤的手术切除需要广泛的解剖，增加了血清肿的风险，血清肿可导致手术部位并发症，如伤口感染和坏死。用异叶欧洲槲寄生（欧洲槲寄生提取物）进行硬化治疗是一种用于减少恶性胸腔积液的相对新技术。在本研究中，我们评估了使用异叶欧洲槲寄生进行预防性硬化治疗以减少巨大脂肪瘤切除术后血清肿的有效性。
我们对2019年1月至2022年12月因颈部巨大脂肪瘤接受手术切除的患者进行了回顾性病历审查。对同意该操作的患者在术后第一天进行硬化治疗，通过现有的Hemovac引流管注入异叶欧洲槲寄生。我们比较了接受术后硬化治疗和未接受术后硬化治疗的患者的临床过程。
在30例接受巨大脂肪瘤切除的患者中，我们对15例患者应用了异叶欧洲槲寄生硬化治疗。接受硬化治疗的患者从手术到拔除Hemovac引流管的平均时间在统计学上较短（p = 0.004）。此外，接受硬化治疗的患者血清肿形成明显减少（p = 0.003）。
在接受巨大脂肪瘤切除的患者中，使用异叶欧洲槲寄生进行硬化治疗有助于在术后初期减少术后血清肿的形成。它可能是减少与血清肿相关的并发症并减轻患者术后负担的一种极好方法。
