BACKGROUND
Bleomycin sclerotherapy became a popular nonsurgical option for the management of lymphangiomas. However, its efficacy has not been thoroughly evaluated. The purpose of this study was to assess the clinical outcomes and the effectiveness of bleomycin injection for the treatment of lymphangioma.
METHODS
This retrospective study was conducted in 4 centers and included 47 infants and children. All patients had bleomycin sclerotherapy between November 2005 and September 2020. Men presented 53.2% of the study sample (n = 25), and the most common site was the head and neck (n = 29, 61.7%).
RESULTS
Two injections were required in 11 patients (23.4%), and 7 patients (14.9%) required 3 or more injections. Excellent response was achieved in 63.8% (n = 30), 14 patients (29.8%) had a good response, and 4 had a poor response (8.5%). There was no difference in the response according to the site of the lesion (p = .75). The most frequent complication was recurrence (n = 11, 23.4%), and swelling occurred in 5 patients (10.6%). No patient had facial or phrenic nerve palsy or hoarseness. Two patients had persistent pain, and 2 had an infection (4.3%).
CONCLUSION
Intralesional bleomycin injection could be an effective therapy for lymphangiomas. The procedure has a low complication profile, and long-term study is recommended to evaluate the systemic and late bleomycin injection complications.
Objectives:
To evaluate the variability in perspectives between pediatric surgeons and pediatric urologists in managing cryptorchidism.
Methods:
We conducted this survey among pediatric surgeons and pediatric urologists managing cryptorchidism in Saudi Arabia in October 2020. We distributed a questionnaire to 187 consultants using the Google forms platform. We collected data related to the consultant’s experience, preoperative management, management of nonpalpable testes, management of palpable undescended testes, management of the cryptorchidism in special situations.
Results:
The response rate was 77% for pediatric surgeons (n=77) and 46% for pediatric urologists (n=40). The number of cases managed by each specialty per year differed significantly (
p
=0.02); however, there was no significant difference in their experience (
p
=0.37). The preferred age for orchidopexy was 6-12 months for both specialties. Pediatric surgeons tend to prescribe preoperative ultrasound more frequently for nonpalpable testes (
p
=0.05). Laparoscopy was the preferred surgical approach by both specialties. Management of intra-abdominal testes not reaching the contralateral internal ring differed between groups (
p
<0.001), and it was related to the number of procedures performed annually (
p
=0.03). Both groups responded differently to the management of unsatisfactory testicular position after orchidopexy (
p
<0.001). Pediatric surgeons managed it with either observation or re-operative inguinal orchidopexy; however, most pediatric urologists preferred re-operative inguinal orchidopexy. This response was affected by the number of procedures performed annually (
p
=0.04).
Conclusion:
In Saudi Arabia, practicing pediatric surgeons and pediatric urologists have different perspectives in the management of cryptorchidism. The results of this survey demonstrated the need to establish national guidelines to manage patients with cryptorchidism.
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