Laparoscopic assisted sclerotherapy in pediatric intra-abdominal cystic lymphatic malformations

Abstract

Background Sclerotherapy is an effective treatment for CLMs of the head and neck. However, Management of intra-abdominal cystic lymphatic malformations(CLMs) remains debates. The purpose of this study was to examine safety and efficacy of laparoscopic assisted sclerotherapy for intra-abdominal CLMs in pediatric patients. Methods We retrospectively reviewed the patients treated with laparoscopic assisted sclerotherapy for intra-abdominal CLMs at a single tertiary medical center between July 2020 and July 2022.The basic information and clinical data of maximal diameter, dose, reduction of lesion’s volume and complications were analyzed. The efficacy was assessed by comparing the pre-operative and post-operative cross-sectional images. Results 7 patients were included in this study and underwent a total of 9 sclerotherapy sessions. 4 patients were symptomatic and majored in abdominal pain. The primary sclerotherapy did not response in better clinical outcome in 2 patients due to intra-cystic hemorrhage and additional procedure were performed. Lesions in 6 patients reduced ≥90% in volume which met the complete response criteria. No further complications were recorded during the follow-up. Conclusions Laparoscopic assisted sclerotherapy is a safe and effective method of managing intra-abdominal CLMs. Laparoscopy could localize the origin of lesions and provides more accuracy and stabilization during the injection procedure.