Outcomes of surgical treatment for hemangiomas

Abstract

Objective To quantify complications and rates of adverse events associated with surgical excision of hemangiomas in children using a national surgical database. Data source Pediatric American College of Surgeons (ACS) National Surgical Quality Improvement Program® (ACS NSQIP®‐pediatric), years 2012‐2016. Methods Subjects included children under 18 years with a postoperative diagnosis of International Classification of Diseases (ICD), 9th revision code: 228.00 and 228.01, or ICD 10 codes D18.00 and D18.01—hemangioma, any site and hemangioma, of skin and subcutaneous tissue. Results A total of 1180 patients were included. The median age was 3.2 years (interquartile range [IQR] 1.2 to 6.4 years old). No occurrences of deep incisional surgical site infection, nerve injury, mortality, sepsis, septic shock, or blood stream infections were noted. In multivariate analysis, age ≤ 3 years and advanced American Society of Anesthesiologists class were significant predictors of adverse events (P = 0.035 and 0.001, respectively). Conclusions For children with infantile hemangioma who fail to respond or have an incomplete response to medical therapy, surgical resection may be a relatively safe treatment alternative. Children older than 3 years of age with hemangiomas had less surgical adverse events than younger children. Overall, however, the surgical complications rates were low and deemed relatively minor.

External Beam Radiotherapy as an Adjuvant in the Management of Recurrent Digital Heamangiomatous Tumour: A Case Report

“…In a retrospective study of 1180 patients who had surgical excision of heamangiomas, the post operative complications were very minor and considerably low [19]. Thus surgical excision is the treatment of choice for recurrent heamangiomas or those refractory to nonoperative therapy.…”

Progress in the treatment of infantile hemangioma

“…However, for some IH children with vascular malformations and skin scars and even ineffective outcomes and relapse after drug treatment, surgical resection may be an alternative treatment because of its short treatment period, rapid lesion removal, and significant improvement in the appearance of the lesion site. Cheng et al (140) conducted a quantitative analysis of the incidence of complications and adverse events in 1,180 IH children (median age, 3.2 years) with surgical resection of the hemangiomas. The results suggested that surgical resection may be a safe treatment approach for patients with ineffective outcomes and incomplete treatment.…”

Infantile Hemangioma: A Common Lesion in a Vulnerable Population

“…Recognition of vascular tumors such as IH is crucial because they are the most common tumor of infancy [ 1 ]. While IH can be life threatening, the majority of these lesions resolve on their own [ 2 ]. The difficulty lies in the fact that there is no reliable method for determining which lesions will spontaneously resolve and which lesions will need intervention.…”