Chylous content might determine the optimal surgical approach for mesenteric lymphatic malformations in childhood

Gasparella, Paolo; Beqo, Besiana P.; Haxhija, Emir Q.; Castellani, Christoph; Arneitz, Christoph; Sorantin, Erich; Kampelmühler, Eva; Singer, Georg; Till, Holger

doi:10.1016/j.jvsv.2021.06.008

Cited by 5 publications

(2 citation statements)

References 23 publications

(33 reference statements)

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“…Complete excision is the treatment of choice to avoid the risk of recurrence. However, complete resection might not always be feasible because most of the MCs were multilocular, without a definite margin, and with the potential involvement of major blood vessels and/or visceral organs ( 14 ). MCs still carried relatively high recurrence rates after surgery, especially for those located at the root of the mesentery and closely involved in major mesenteric vessels ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

Robotic-assisted laparoscopic management of mesenteric cysts in children

et al. 2023

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BackgroundMesenteric cysts (MCs) are rare intra-abdominal masses in children, and laparoscopic complete cyst resection is still difficult. This study reviewed our experience in diagnosing and managing MCs at our center, focusing on the clinical characteristics of MCs and the effectiveness of robotic-assisted laparoscopic surgery.MethodsWe conducted a retrospective analysis of the records of all patients diagnosed with MCs and managed with robotic-assisted laparoscopic surgery at our center between February 2021 and August 2022. We analyzed demographic characteristics, clinical manifestations, preoperative imaging data, surgical methods, postoperative complications, and final outcomes.ResultsTotally, 12 consecutive patients with a mean age of 5.81 ± 3.02 years were admitted. The most common symptom was abdominal pain (58.33%). Eight patients were associated with cyst complications, including five cases of infection, two cases of volvulus, and one case of hemorrhage. The mean size of cysts was 8.39 ± 5.91 cm. The cysts were located in ileal mesentery in eight cases, lesser curvature of the stomach in two cases, and colon mesentery in two cases. Solely cyst excision was performed in eight cases, and bowel en bloc resection of the cyst in four cases. Robotic-assisted laparoscopic surgery was performed successfully in all patients, without conversion. The mean operation time was 106.17 ± 33.74 min. Pathological results reported lymphangioma or lymphatic malformation in all patients. Two cases of chylous leakage were treated conservatively, and no complications of peritoneal infection, anastomotic leakage, and recurrence were observed.ConclusionsMesenteric cysts should be removed promptly once the diagnosis is confirmed to avoid cyst complications. For uncomplicated mesenteric cysts, laparoscopic cyst excision, or cyst excision with bowel resection can be effectively performed in children, especially under the robot system.

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Section: Discussionmentioning

confidence: 99%

Robotic-assisted laparoscopic management of mesenteric cysts in children

et al. 2023

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“…В нашей выборке 3 больным был выполнен этот анализ, у всех получены положительные результаты, назначен таргетный препарат алпелисиб с хорошим эффектом. При формировании хилёзных выпотов в послеоперационном периоде у больных без генетического анализа невозможно достоверно определить причину развития этой формы патологии [39,40]. Выяснение причины позволит назначить патогенетическую терапию и улучшить прогноз.…”

Section: Discussionunclassified

Diagnosis and treatment of lymphatic malformations: experience of the surgical department for newborns and infants

Gurskaya,

Sulavko,

Bayazitov

et al. 2023

RPJ

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Introduction. Lymphatic malformations (LM) are a congenital pathology of lymphatic vessels that arose during embryogenesis. The relevance of the research topic is due to the rarity, variety of clinical manifestations, and the lack of clinical recommendations for treatment. Aim. To evaluate our experience of surgical and conservative treatment of LM in the surgical department for newborns and infants. Materials and methods. We performed a retrospective analysis of infants with various forms of LM treated at our department from 2017 to 2022. The study protocol was approved by the local ethics committee. The patients’ parents gave written voluntary informed consent to participate in the study. Results. Depending on the form of a LM, the infants underwent conservative therapy, sclerotherapy or surgical resection of the LM. Conclusions. Genetic tests for the spectrum of overgrowth syndromes are necessary for all LM patients to clarify the etiology of the process, prevent recurrence and complications.

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