Efficacy of bleomycin for non-operative treatment of cervical lymphangioma in University of Ilorin Teaching Hospital, Nigeria

Objective: Main purpose of this study is to compare the outcomes of sclerotherapy with bleomycin versus surgical resection in children with cystic hygroma. Study Design: Comparative/Observational study Place and Duration: This observational study was conducted at Children Surgical Hospital, Sialkot for six months during the period from July 2020 to December 2020. Methods: Total 50 children of both genders were presented. Children were aged between 2-12 years. All the patients had cystic hygroma were included. Informed written consent was taken from parents of children for detailed demographics. Patients were equally divided into two groups, group I had 25 patients and received sclerotherapy with bleomycin and group II received surgical resection among 25 cases. Post-treatment outcomes were assessed and compared in terms of efficacy and recurrence among both groups. SPSS 22.0 version was used to analyze complete data. Results: Majority were males in group I and II (68% and 64%) and females were 8 (32%) in group I and 9 (36%) in group II. In group I 18 (72% cases) were <6years of age and in group II 19 (76%) children were < 6years of age. Neck and axilla was the most effected site of cystic hygroma followed by face and trunk. We found that effectiveness of sclerotherapy with bleomycin was higher among 21 (84%) cases as compared to surgical resection 19 (76%). Recurrence rate was higher in group II 5 (20%) as compared to group I 3 (12%). Wound infection was lower in group I 1 (4%) and in group II we found 3 (12%). Conclusion: In this research we concluded that use of sclerotherapy with bleomycin is an effective and safe treatment for cystic hygroma as compared to surgical resection in terms of less recurrence rate, wound infection and higher number of good results. Keywords: Cystic hygroma, Children, Sclerotherpay, Bleomycin, Surgical Resection

Section: Discussionsupporting

confidence: 92%

Comparative Analysis of Sclerotherapy with Bleomycin Versus Surgical Resection for Cystic Hygroma in Children

Rehman¹,

Butt²,

Waheed³

et al. 2021

“…There was a significant difference between both groups (p=<0.001). These results were similar to many of previous studies in which surgical excision had high rate of wound infection 5 to 20% and recurrence rate 10 to 30% as compared to sclerotherapy [15][16]. We observed that surgical excision needs much per-operative care as compared to sclerotherapy.…”

Section: Discussionsupporting

confidence: 91%

Compare the Outcomes of Sclerotherapy with Bleomycin Versus Surgical Resection in Children with Cystic Hygroma

Khan¹,

Zada²,

Shah³

et al. 2021

Objective: To compare the outcomes of sclerotherapy with bleomycin versus surgical resection in children with cystic hygroma. Study Design: Comparative/Observational Place and Duration: Paediatric department of Khalifa Gul Nawaz Medical Teaching Institute, Bannu for 20 months duration from 1st August 2019 to 31st March 2021. Methods: Total 40 patients of both genders with ages 1 month to 15 years presented with cystic hygroma were included in this study. Patients' detailed demographics were recorded after written consent from parents/guardians. Patients were divided in to two groups’ i.e. Group A consist of 20 patients and received sclerotherapy with intra-lesional bleomycin and Group B consist of 20 patients received surgical excision. Outcomes were analyzed at post-procedure 3 and 6 months post-procedure and compared the findings between both groups. Results: There was no significant difference observed between both groups regarding age, gender and site of lymphangioma p-value >0.05. In Group A 15 (75%) patients showed excellent results, 3 (15%) patients showed good results and 2 (10%) showed poor results. In Group B 13 (65%) showed excellent results, 4 (20%) showed good results and 3 (15%) showed poor results. At final follow-up there were no patient with recurrence in Group A while in Group B 2 (10%) patients had recurrence, Conclusion: It is concluded that sclerosing treatment with bleomycin is a safe and effective treatment modality with no recurrence as compared to surgical rexection. Keywords: Cystic Hygroma, Sclerotherapy, Bleomycin, Surgery, Recurrence

“…[25] Frequency of wound infection 3 (11.5%) and recurrence rate 2 (7.7%) was in group II but there was no any recurrence found in group I and wound infection found only in 1 (3.8%) children. Previous research has shown that surgical excision has a higher recurrence and wound infection incidence than sclerotherapy [26,27]. The amount of post-operative care required for hypertonic solution is substantially more than for sclerotherapy, as we noticed.…”

Section: Discussionsupporting

confidence: 53%

Compare the Outcomes of Sclerotherapy with Bleomycin Versus 15% Hypertonic Saline in Children with Cystic Hygroma

Pandit¹,

Pandit²,

Abbassi³

et al. 2022

Objective: The goal of this research is to evaluate the efficacy of bleomycin sclerotherapy against hypertonic saline (at 15%) in treating cystic hygroma in children. Study Design: Comparative study Place and Duration: Children Hospital, Pakistan Institute of Medical Sciences PIMS Islamabad. July 2021-Feb 2022. Methods: There were 52 children of both genders with cystic hygroma were included in this study. Included children had age 2 months to 12 years. After taking informed written consent from the parents of children detailed demographics age, sex, weight and place of living were recorded. Patients were equally categorized in two groups. 26 patients in group I received sclerotherapy with bleomycin and in group II 26 children received 15% hypertonic saline. Post-treat outcomes among both groups were assessed and compared. SPSS 22.0 was used to analyze all data. Results: Among 52 children, there were 32 (61.5%) males and 20 (38.5%) females. Mean weight of the children was 14.7±5.37 kg and mean age was 6.9±9.54 years. Majority of the cases 34 (65.4%) were from rural areas and 18 (34.6%) were had urban residency. Most common site of lymphangioma was neck and axilla. In group I 18 (69.2%) children received four sessions of bleomycin. We found higher number of effectiveness in patients of group I 25 (96.2%) as compared to group II in 22 (84.6%) cases with p value <0.009. Frequency of wound infection and recurrence rate was also higher in group II. Conclusion: We concluded in this study that the use of sclerotherapy with bleomycin was an effective and useful in the treatment cystic hygroma children in terms of higher number of excellent results as compared to 15% hypertonic saline. Except this recurrence rate and complications were also not seen in sclerotherapy with bleomycin group. Keywords: Bleomycin, Sclerotherapy, Cystic Hygroma, Recurrence, Wound Infection, 15% Hypertonic Saline