Laparoscopic surgery of intra‑abdominal lymphatic malformation in children

Liu,Qianlong; Fu,Jialu; Yu,Qiang; Gong,Wei; Li,Peng; Guo,Xinkui

doi:10.3892/etm.2022.11519

Laparoscopic surgery of intra‑abdominal lymphatic malformation in children

Authors:
- Qianlong Liu
- Jialu Fu
- Qiang Yu
- Wei Gong
- Peng Li
- Xinkui Guo
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Affiliations: Department of Pediatric Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
Published online on: July 19, 2022 https://doi.org/10.3892/etm.2022.11519
Article Number: 581
Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Lymphatic malformation (LM) in the abdomen is uncommon in children, and the standard treatment is surgical excision. The present study aimed to evaluate the safety and efficacy of laparoscopic surgery of intra‑abdominal LM in a pediatric population. The medical records of 10 children with intra‑abdominal LM treated by laparoscopic resection from March 2017 to June 2021 in The Second Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) were retrospectively reviewed. Equal numbers of female and male patients were included and underwent surgery at the median age of 55 months (range, 40 days‑94 months). Abdominal pain was the most frequent symptom presenting in eight patients (80%). All children were referral patients, and half of them presented to the emergency department with acute abdominal pain. All 10 of the patients benefited from laparoscopic treatment; three patients underwent extraperitoneal segmental intestinal resection and anastomosis via an enlarged umbilical incision, and two patients were converted to laparotomy because of a large retroperitoneal LM with involvement of the colon. No recurrence or complications occurred in the patients during the follow‑up period with mean of 35 months (range, 11‑60 months) after surgery. Overall, laparoscopic resection of intra‑abdominal LM was an effective, minimally invasive therapy in the pediatric population. Segmental intestinal resection is usually required to achieve the complete removal of lesions to lessen the risk for recurrence.

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1	Elluru RG, Balakrishnan K and Padua HM: Lymphatic malformations: Diagnosis and management. Semin Pediatr Surg. 23:178–185. 2014.PubMed/NCBI View Article : Google Scholar
2	Kulungowski AM and Patel M: Lymphatic malformations. Semin Pediatr Surg. 29(150971)2020.PubMed/NCBI View Article : Google Scholar
3	Makni A, Chebbi F, Fetirich F, Ksantini R, Bedioui H, Jouini M, Kacem M and Ben Safta Z: Surgical management of intra-abdominal cystic lymphangioma. Report of 20 cases. World J Surg. 36:1037–1043. 2012.PubMed/NCBI View Article : Google Scholar
4	Kim SH, Kim HY, Lee C, Min HS and Jung SE: Clinical features of mesenteric lymphatic malformation in children. J Pediatr Surg. 51:582–587. 2016.PubMed/NCBI View Article : Google Scholar
5	Kronfli AP, McLaughlin CJ, Moroco AE and Grant CN: Lymphatic malformations: A 20-year single institution experience. Pediatr Surg Int. 37:783–790. 2021.PubMed/NCBI View Article : Google Scholar
6	Russell KW, Rollins MD, Feola GP, Arnold R, Barnhart DC and Scaife ER: Sclerotherapy for intra-abdominal lymphatic malformations in children. Eur J Pediatr Surg. 24:317–321. 2014.PubMed/NCBI View Article : Google Scholar
7	Madsen HJ, Annam A, Harned R, Nakano TA, Larroque LO and Kulungowski AM: Symptom resolution and volumetric reduction of abdominal lymphatic malformations with sclerotherapy. J Surg Res. 233:256–261. 2019.PubMed/NCBI View Article : Google Scholar
8	Michael LF, White CL, Oliveri B, Lee EY and Restrepo R: Intraabdominal lymphatic malformations: Pearls and pitfalls of diagnosis and differential diagnoses in pediatric patients. AJR Am J Roentgenol. 208:637–649. 2017.PubMed/NCBI View Article : Google Scholar
9	Poroes F, Petermann D, Andrejevic-Blant S, Labgaa I and Di Mare L: Pediatric cystic lymphangioma of the retroperitoneum: A case report and review of the literature. Medicine (Baltimore). 99(e20827)2020.PubMed/NCBI View Article : Google Scholar
10	McHoney M, Kiely EM and Mushtaq I: Color Atlas of Pediatric Anatomy, Laparoscopy, and Thoracoscopy. Springer Berlin Heidelberg, Berlin, Heidelberg, 2017.
11	Zhuo CH, Shi DB, Ying MG, Cheng YF, Wang YW, Zhang WM, Cai SJ and Li XX: Laparoscopic segmental colectomy for colonic lymphangiomas: A definitive, minimally invasive surgical option. World J Gastroenterol. 20:8745–8750. 2014.PubMed/NCBI View Article : Google Scholar
12	Takiff H, Calabria R, Yin L and Stabile BE: Mesenteric cysts and intra-abdominal cystic lymphangiomas. Arch Surg. 120:1266–1269. 1985.PubMed/NCBI View Article : Google Scholar
13	Chaudry G, Burrows PE, Padua HM, Dillon BJ, Fishman SJ and Alomari AI: Sclerotherapy of abdominal lymphatic malformations with doxycycline. J Vasc Interv Radiol. 22:1431–1435. 2011.PubMed/NCBI View Article : Google Scholar
14	Thomas DM, Wieck MM, Grant CN, Dossa A, Nowicki D, Stanley P, Zeinati C, Howell LK and Anselmo DM: Doxycycline sclerotherapy is superior in the treatment of pediatric lymphatic malformations. J Vasc Interv Radiol. 27:1846–1856. 2016.PubMed/NCBI View Article : Google Scholar
15	Acord M, Srinivasan AS and Cahill AM: Percutaneous treatment of lymphatic malformations. Tech Vasc Interv Radiol. 19:305–311. 2016.PubMed/NCBI View Article : Google Scholar
16	Shayesteh S, Salimian KJ, Fouladi DF, Blanco A, Fishman EK and Kawamoto S: Intra-abdominal lymphangioma: A case report. Radiol Case Rep. 16:123–127. 2020.PubMed/NCBI View Article : Google Scholar
17	Gasparella P, Singer G, Castellani C, Sorantin E, Haxhija EQ and Till H: Giant lymphatic malformation causing abdominal compartment syndrome in a neonate: A rare surgical emergency. J Surg Case Rep. 2020(rjaa252)2020.PubMed/NCBI View Article : Google Scholar
18	Cauley CE, Spencer PJ, Sagar P and Goldstein AM: Giant mesenteric lymphatic malformation presenting as small bowel volvulus. J Surg Case Rep. 2013(rjt083)2013.PubMed/NCBI View Article : Google Scholar
19	Lal A, Gupta P, Singhal M, Sinha SK, Lal S, Rana S and Khandelwal N: Abdominal lymphatic malformation: Spectrum of imaging findings. Indian J Radiol Imaging. 26:423–428. 2016.PubMed/NCBI View Article : Google Scholar
20	Sriram G, Zendejas B, Vargas SO and Chen C: Colonic mesenteric lymphatic malformation presenting as an intraabdominal abscess in an infant: A case report. Int J Surg Case Rep. 39:154–158. 2017.PubMed/NCBI View Article : Google Scholar