Effıcıency And Clınıcal Results Of Bleomısın Injectıon In The Treatment Of Lymphatıc Malformatıons

Abstract

INTRODUCTION: Lymphatic malformations (LM) are rare congenital anomalies. The traditional treatment is surgical excision, but intralesional sclerosing agent injection is now preferred because of frequent recurrences after surgery, poor cosmetic results, and a high complication rate. We aimed to evaluate the efficacy of sclerosing agent injection used in the treatment of LMs in children. MATERIALS AND METHODS: We retrospectively analyzed the age, gender, admission symptoms, physical examination findings, radiological imaging results, treatment methods, complications, length of hospital stay, and outcomes of children treated for LM between January 2011 and January 2022. The lesion sizes of the patients who underwent sclerosant (Bleomycin) injection under general anesthesia were recorded before and after the treatment, and the difference between them was evaluated statistically. RESULTS: Fifteen patients were retrospectively analyzed. The mean age was 45.2+- 14.1 months (min:3- median:17- max:210). Of these, 10 (66.6%) were male and 5 (33.3%) were female (F/M=1/2). The mean age of male patients was 55 +- 20.1 months (min :3- max:210 months); The mean age of the female patients was 25.8 + - 11.2 (min 3- max: 66 months). Seven patients had a single dose, two had twice and six had three and more. Three patients had LM in different localisations simultaneously. After the sclerosant injection, surgery was performed on 2 patients, and the tissue that became a mass was removed. The average lesion size before the treatment was 55.2+-28.4 mm; after treatment: 23.8+-18.2mm. With the statistical analysis, it was seen that there was a statistically significant difference between the dimensions before and after the treatment (p<0.05) and the sclerosant injection had a great effect on the treatment (R:0.89). CONCLUSION: Intralesional injection of bleomycin is less effective for microcystic or mixed type LMs, but provides effective reduction for a safe surgical procedure. It is an effective treatment for macrocystic lesions.