Mesenteric and omental lymphatic malformations in children: seven-year surgical experience from two centers in China

Abstract

Purpose To compare the clinical characteristics, surgical management and prognosis of mesenteric lymphatic malformations (ML) and omental lymphatic malformations (OL) in children. Methods This retrospective study included 148 ML patients and 53 OL patients who underwent surgical treatment at two centers between January 2016 and December 2022. Details of the patients’ clinical characteristics, cyst characteristics, preoperative complications, surgical methods, and prognosis were retrieved and compared. Results No significant differences between ML and OL patients were noted in sex ratio, prenatal diagnosis, and age of diagnosis. The presence of vomiting was more common in ML patients than in OL patients (46.6% vs. 22.6%, P = 0.002), but OL patients were more likely to be misdiagnosed (35.8% vs. 18.8%, P = 0.012). The size of cysts in OL patients was significantly larger than that in ML patients (14.0 [8.0, 17.3] vs. 10.0 [6.0, 13.0] cm, P＜0.001), and cysts with turbid fluid were more common in OL patients (38.0% vs. 20.6%, P＜0.001). Cyst excision was performed in 137 (92.6%) ML patients and 51 (96.2%) OL patients, and the incidence of postoperative complications was lower (12.6% vs. 4.2%, P = 0.165) among the latter. The main postoperative complications included adhesive ileus and recurrence of cysts. Additionally, laparoscopic surgery was more commonly undergone among OL patients (69.8% vs. 39.2%, P＜0.001). Conclusions Compared with ML patients, OL patients are more prone to misdiagnosis and infection, but the prognosis of surgical treatment is better. Laparoscopic cyst excision may be the preferred treatment for OL patients.