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Sclerotherapy with bleomycin versus surgical excision for extracervical cystic lymphatic malformations in children

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Abstract

Purpose

Sclerotherapy (ST) with bleomycin is an effective treatment for cervical cystic lymphatic malformations (LM) in children. However, its efficacy for treating extracervical cystic LM in children has not been investigated adequately. This retrospective study compares the efficacy of ST with surgery for treating extracervical cystic LM in children.

Methods

The subjects of this study were children treated for extracervical cystic LM at our hospital between 1970 and 2013. We evaluated retrospectively the hospital records of these children for age, gender, presenting symptoms, location of the lesion, radiological findings, treatments, complications, duration of hospitalization, and outcome.

Results

We analyzed the records of 70 children (M:F = 1:9) with a mean age of 52.57 ± 54.87 months (range 1–204 months). The number of children treated by surgery alone, ST alone, and surgery plus ST was 53 (77 %), 13 (18 %), and 4 (5 %), respectively. Surgery comprised total excision (n = 41), near-total excision (n = 9), partial excision (n = 6), and incisional biopsy (n = 1). The complication and recurrence rates were lower, the complete response rate was higher, and the length of hospitalization was shorter in the ST group than in the surgery group (5 vs. 15 % and 8 vs. 17 %, respectively, p < 0.05; 91 vs. 77 %, respectively, p = 0.05; and 2.42 ± 1.67 vs. 13.57 ± 16.24 days, respectively, p = 0.03).

Conclusion

ST is as safe as surgery for extracervical macrocystic or mixed LMs in children, but is much more effective with higher success rates and lower recurrence rates. Thus, ST provides a cost-effective and appropriate mode of treatment for children with extracervical cystic LM.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey

    Burak Ardıçlı, İbrahim Karnak, Arbay Ö. Çiftçi, F. Cahit Tanyel & M. Emin Şenocak

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  1. Burak Ardıçlı
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  2. İbrahim Karnak
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  3. Arbay Ö. Çiftçi
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  4. F. Cahit Tanyel
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  5. M. Emin Şenocak
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Correspondence to İbrahim Karnak.

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Ardıçlı, B., Karnak, İ., Çiftçi, A.Ö. et al. Sclerotherapy with bleomycin versus surgical excision for extracervical cystic lymphatic malformations in children. Surg Today 46, 97–101 (2016). https://doi.org/10.1007/s00595-015-1128-0

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  • DOI: https://doi.org/10.1007/s00595-015-1128-0

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