Diagnosis and treatment of lymphatic malformation with mini-invasive negative pressure aspiration in children: a report of 25 cases

Abstract

Objective To explore the efficacy of mini-invasive negative pressure aspiration for pediatric lymphatic malformations. Methods A total of 25 cases of lymphatic malformation were reviewed from June 2015 to June 2017. There were 12 boys and 13 girls with an average age of (5.33±2.49)(3-14) years. All lesions were located in subcutaneous tissues and none in visceral organs or fingers (toes). The sites were face (n=3), chest (n=1), abdomen (n=1), back (n=1) and extremity (n=19). Preoperative sclerotherapy was prescribed for 1-3 times within 6 months. The efficacy was non-satisfactory. Nineteen mixed lymphatic malformations and 6 microlymphatic malformations were confirmed ultrasonically. The thickness of lesion was recorded. Operation was assisted by B-ultrasound under general anesthesia and tumescent liquid injected through a small incision with an injection needle. Wound was aspirated with a negative liposuction needle. The specimens were submitted for pathological examination. A drainage catheter was retained postoperatively and elastic suit immediately applied. The average postoperative follow-up period was (14.24±5.45)(6-24) months. The ultrasonic thickness of lesion was recorded for statistical analysis. Results There was no occurrence of lidocaine poisoning, intracapsular hemorrhage, infection, neurovascular injury, thrombosis or fat embolism. Varying extent of edema in operative field improved significantly within 1 month. In 2 cases, incision exuded after removing drainage catheter. Incision healed at Days 11 and 13 postoperatively. Twenty-three of them healed well with minimal scarring. Drainage catheter was retained for (4.60±1.55)days post-operation and liquid was clear. No exudation occurred within (12.24±2.82)days. Pathological examination confirmed the diagnosis of lymphatic malformation. All external appearances improved obviously and edema completely subsided. There was no injury of muscle, blood vessel or nerve. The effective rate was 100%, and there was no recurrence within 6 months. The difference between preoperative and postoperative thickest lesions was statistically significant [(2.39±0.81) vs (1.02±0.35) cm, P<0.05]. Conclusions With minimal trauma and scarring and optimal cosmetics, mini-invasive negative pressure aspiration is effective for pediatric lymphatic malformations. Key words: Lymphatic vessel; Malformation; Tumescent liposuction