The optimal management of microcystic lymphatic malformations (LMs) in children has not been established. We describe how we used the Ligasure™ Vessel Sealing System (LVSS) to achieve partial resection of refractory microcystic LMs in a 1-year-old boy. The child was admitted in respiratory distress caused by infection and swelling of cervical LMs. The LMs had been diagnosed prenatally, but had not decreased in size despite three treatments with OK-432 sclerotherapy. We performed direct dissection of the microcystic LMs using the LVSS with minimal intraoperative blood loss or lymphatic leakage. The LMs were resected as completely as possible without damage to the jugular vein or major nerves. His postoperative course was uneventful. Histological examination revealed complete sealing of the lymphovascular channels with obliterated lumens. Resection using the LVSS is effective and easy to perform for partial resection of microcystic LMs. We recommend the combination of initial OK-432 injection therapy and subsequent partial resection using the LVSS for refractory microcystic LMs.
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Article Synopsis
- The study aimed to identify factors associated with permanent complications after surgery for lymphatic malformations (LMs) in children, emphasizing the need for selective surgical intervention.
- Out of 112 children operated on between 2001 and 2021, younger patients (under 1 year) and those with cervicofacial and microcystic LMs faced higher complication rates, mostly neurological.
- The findings suggest that less aggressive surgical methods may lead to fewer complications without compromising long-term cure rates, advocating for caution in surgical approaches.
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