Preoperative complications in children with mesenteric lymphatic malformations: Incidence, risk factors and outcomes

Yan, Jiayu; Wang, Li; Xie, Chuanping; Peng, Chunhui; Pang, Wenbo; Chen, Yajun

doi:10.3389/fped.2022.1033897

Cited by 3 publications

(10 citation statements)

References 20 publications

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“…In this series, 66.67% (8/12) patients were associated with MC complications, including five cases of infection, two cases of volvulus, and one case of hemorrhage. It was recommended that MCs should be removed as early as possible after diagnosis was confirmed ( 3 , 6 , 13 ). Complete excision is the treatment of choice to avoid the risk of recurrence.…”

Section: Discussionmentioning

confidence: 99%

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Robotic-assisted laparoscopic management of mesenteric cysts in children

et al. 2023

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BackgroundMesenteric cysts (MCs) are rare intra-abdominal masses in children, and laparoscopic complete cyst resection is still difficult. This study reviewed our experience in diagnosing and managing MCs at our center, focusing on the clinical characteristics of MCs and the effectiveness of robotic-assisted laparoscopic surgery.MethodsWe conducted a retrospective analysis of the records of all patients diagnosed with MCs and managed with robotic-assisted laparoscopic surgery at our center between February 2021 and August 2022. We analyzed demographic characteristics, clinical manifestations, preoperative imaging data, surgical methods, postoperative complications, and final outcomes.ResultsTotally, 12 consecutive patients with a mean age of 5.81 ± 3.02 years were admitted. The most common symptom was abdominal pain (58.33%). Eight patients were associated with cyst complications, including five cases of infection, two cases of volvulus, and one case of hemorrhage. The mean size of cysts was 8.39 ± 5.91 cm. The cysts were located in ileal mesentery in eight cases, lesser curvature of the stomach in two cases, and colon mesentery in two cases. Solely cyst excision was performed in eight cases, and bowel en bloc resection of the cyst in four cases. Robotic-assisted laparoscopic surgery was performed successfully in all patients, without conversion. The mean operation time was 106.17 ± 33.74 min. Pathological results reported lymphangioma or lymphatic malformation in all patients. Two cases of chylous leakage were treated conservatively, and no complications of peritoneal infection, anastomotic leakage, and recurrence were observed.ConclusionsMesenteric cysts should be removed promptly once the diagnosis is confirmed to avoid cyst complications. For uncomplicated mesenteric cysts, laparoscopic cyst excision, or cyst excision with bowel resection can be effectively performed in children, especially under the robot system.

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Section: Discussionmentioning

confidence: 99%

“…Surgical excision is usually recommended once the diagnosis is made ( 3 , 5 , 6 ). Asymptomatic cysts smaller than 5 cm can be observed closely.…”

Section: Introductionmentioning

confidence: 99%

Robotic-assisted laparoscopic management of mesenteric cysts in children

et al. 2023

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“…According to previous studies, the preoperative complications of ML and OL mainly included hemorrhage, infection and rupture of the cyst, and intestinal or omental volvulus caused by the cyst [6]. However, hemorrhage and infection of cyst are often concomitant and challenging to distinguish [11].…”

Section: Methodsmentioning

confidence: 99%

“…The size of the cysts referred to the length of the entire cyst obtained from surgical records for patients undergoing open surgery and from preoperative imaging ndings for patients undergoing laparoscopic surgery. The cysts of ML and OL could contain serous, chylous, or turbid uid, including serosanguinous uid caused by hemorrhage or infection of the cyst [6,11]. According to the surgical approach, surgical methods could be divided into open surgery (including laparoscopic conversion to open surgery) and laparoscopic surgery (including laparoscopic-assisted surgery and robot-assisted surgery).…”

Section: Methodsmentioning

confidence: 99%

“…The recommended treatment for OL is complete surgical resection. The initial symptoms of ML and OL patients are usually vague and almost similar, but symptoms can be aggravated when the size of a cyst increases or complications occur [11,12]. In addition, apart from the absence of intermixing between the uid and loops of the bowel being a possible clue to the presence of OL, preoperative imaging examinations can hardly distinguish OL from ML [13].…”

Section: Introductionmentioning

confidence: 99%

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

Yan

Fu²,

Liu

et al. 2023

Preprint

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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.

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

Yan,

Fu,

Liu

et al. 2024

BMC Pediatr

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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 about the patients’ clinical characteristics, cyst characteristics, preoperative complications, surgical methods, and prognosis were retrieved and compared. Results No significant differences in sex ratio, prenatal diagnosis, or age of diagnosis were noted between ML and OL patients. 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. 18.9%, P = 0.012). The size of the cysts in OL patients was significantly larger than that in ML patients (14.0 [4.0–30.0] vs. 10.0 [2.0–50.0] cm, P<0.001), and cysts with turbid fluid were more common in OL patients (38.0% vs. 20.6%, P<0.001). More OL patients than ML patients had preoperative hemorrhage or infection of cysts (41.5% vs. 31.8%, P<0.016). 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 OL patients. The main postoperative complications included adhesive ileus and recurrence of cysts. Additionally, more OL patients than ML patients were treated with laparoscopic surgery (69.8% vs. 39.2%, P<0.001). Conclusions There were differences in clinical characteristics, cyst characteristics and preoperative complications between ML and OL patients. Cyst excision was the most common surgical method that was used to treat both ML and OL patients, and laparoscopic surgery could be a feasible surgical approach for treating OL patients with a good prognosis. Trial registration Retrospectively registered.

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Preoperative complications in children with mesenteric lymphatic malformations: Incidence, risk factors and outcomes

Cited by 3 publications

References 20 publications

Robotic-assisted laparoscopic management of mesenteric cysts in children

Robotic-assisted laparoscopic management of mesenteric cysts in children

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

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

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