Retroperitoneal Cystic Lymphangioma: A Rare Presentation in Childhood, Treated Laparoscopically

Singh, Rashmi R.; Govindarajan, Krishna Kumar; Bowen, Claire; Chandran, Harish

doi:10.1089/lap.2008.0234

Cited by 16 publications

(9 citation statements)

References 6 publications

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“…Re-do aortopexy was reported in less than 1% of cases. Other surgical procedures performed before, in association with, or after, aortopexy were; vascular ring division (17.5%), external or internal stenting of the trachea (5%), tracheal resection or tracheoplasty (3.7%), and tracheopexy (1.3%) Three studies reported a predisposition of the patients to get chest infections, even long after aortopexy [11,13,14]. …”

Section: Resultsmentioning

confidence: 99%

“…Left anterior thoracotomy can be considered the preferred approach by the vast majority of surgeons (72% of the patients received a left anterior thoracotomy), but up to one third of the patients are treated with other surgical approaches. Thoracoscopy has been used in 1% of cases, belonging to three centres, though apparently with satisfactory results, [4,13,17]. The theoretical advantage of thoracoscopic aortopexy is obviously to reduce the postoperative pain and the morbidity of a thoracotomy or sternotomy.…”

Section: Discussionmentioning

confidence: 99%

“…The persistence of respiratory infections for many years after aortopexy as reported by three different reports [11,13,14] may suggest that the airway in TM patients remains for some reason prone to this episodes despite the resolution of the respiratory distress and therefore the patients should be followed carefully by their Paediatricians and Respiratory Physicians.…”

Section: Discussionmentioning

confidence: 99%

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Aortopexy for the treatment of tracheomalacia in children: review of the literature

et al. 2012

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Severe tracheomalacia presents a significant challenge for Paediatricians, Intensivists, Respiratory Physicians, Otolaryngologists and Paediatric Surgeons. The treatment of tracheomacia remains controversial, but aortopexy is considered by most to be one of the best options. We conducted a review of the English literature relating to aortopexy.Among 125 papers, 40 have been included in this review. Among 758 patients (62% males) affected with tracheomalacia, 581 underwent aortopexy. Associated co-morbidities were reported in 659 patients. The most frequent association was with oesophageal atresia (44%), vascular ring or large vessel anomalies (18%) and innominate artery compression (16%); in 9% tracheomalacia was idiopathic. The symptoms reported were various, but the most important indication for aortopexy was an acute life-threatening event (ALTE), observed in 43% of patients. The main preoperative investigation was bronchoscopy. Surgical approach was through a left anterior thoracotomy in 72% of patients, while median approach was chosen in 14% and in 1.3% a thoracoscopic aortopexy was performed. At follow-up (median 47 months) more than 80% of the patients improved significantly, but 8% showed no improvement, 4% had a worsening of their symptoms and 6% died. Complications were observed in 15% of patients, in 1% a redo aortopexy was deemed necessary.In our review, we found a lack of general consensus about symptom description and evaluation, indications for surgery, though ALTE and bronchoscopy were considered by all an absolute indication to aortopexy and the gold standard for the diagnosis of tracheomalacia, respectively. Differences were reported also in surgical approaches and technical details, so that the same term “aortopexy” was used to describe different types of procedures. Whatever approach or technique was used, the efficacy of aortopexy was reported as high in the majority of cases (more than 80%). A subgroup of patients particularly delicate is represented by those with associated gastro-esophageal reflux, in whom a fundoplication should be performed. Other treatments of tracheomalacia, particularly tracheal stenting, were associated with a higher rate of failure, severe morbidity and mortality.Non english abstractLa tracheomalacia severa rappresenta una sfida per Pediatri, Intensivisti, Pneumologi, Otorinolaringoiatri, Chirurghi Pediatri. Il trattamento della tracheomalacia è tuttora controverso. L’aortopessi è considerata da molti la migliore opzione terapeutica. Abbiamo condotto una revisione della letteratura di lingua inglese su tale argomento.Di 125 lavori, 40 sono stati inclusi nella revisione. Tra 758 pazienti (62% maschi) affetti da tracheomalacia, 581 sono stati sottoposti ad aortopessi tra il 1968 e il 2008. In 659 pazienti alcune comorbidità erano presenti. L’associazione più frequente era con l’atresia esofagea (44%), l’anello vascolare o un’anomalia dei grossi vasi (18%), la compressione da parte dell’arteria innominata (16%); nel 9% la tracheomalacia era idiopatica. I sinto...

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Aortopexy for the treatment of tracheomalacia in children: review of the literature

et al. 2012

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“…Laparoscopic excision of the retroperitoneal CL in children is rarely reported in the literature (5,9). According to a recent literature review, there are only three reported retroperitoneal CL cases which were successfully excised by laparoscopy in children, but none of them was located in the adrenal region (13).…”

Section: Adrenal Cystic Lymphangiomamentioning

confidence: 99%

Adrenal Cystic Lymphangioma

2015

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“…Surgery for large neonatal abdominal lymphatic malformations has generally required laparotomy [7]. However, in older children, several centers have reported laparoscopic excision [8][9][10]. In neonates, laparoscopic-only approaches appear rare and confined to mesenteric lymphatic malformations [2,[11][12][13].…”

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confidence: 99%