Surgical Treatment of Mesenteric Lymphatic Malformations in Children: An Observational Cohort study

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

“…The inpatient data included clinical characteristics (sex, prenatal diagnosis, age of diagnosis, presenting symptoms, misdiagnosis before admission, laboratory examinations, and preoperative imaging examinations), preoperative complications, surgical details, and pathological data. According to previous studies, the preoperative complications of ML and OL mainly included hemorrhage, infection and rupture of the cyst, as well as intestinal or omental volvulus caused by the cyst [ 6 ]. However, hemorrhage and infection of cysts are often concomitant and challenging to distinguish [ 11 ].…”

“…The cyst characteristics included the specific location, classification, pathological type, cyst size, and cyst content. The specific locations of ML varied depending on the mesentery involved, and included intestinal ML, colonic ML and combined ML; the specific locations of OL varied depending on the omentum involved, and included greater ML and lesser ML [ 6 ]. Considering that the previously reported classifications of ML could not be applied to OL, a simple classification of OL reported was used in this study, including Group 1 (patients with clinical features due to the size of the cyst), Group 2 (patients with clinical features due to the preoperative complications of the cyst), and Group 3 (patients without clinical features but whose cysts were incidentally detected) [ 4 , 6 , 17 ].…”

“…The specific locations of ML varied depending on the mesentery involved, and included intestinal ML, colonic ML and combined ML; the specific locations of OL varied depending on the omentum involved, and included greater ML and lesser ML [ 6 ]. Considering that the previously reported classifications of ML could not be applied to OL, a simple classification of OL reported was used in this study, including Group 1 (patients with clinical features due to the size of the cyst), Group 2 (patients with clinical features due to the preoperative complications of the cyst), and Group 3 (patients without clinical features but whose cysts were incidentally detected) [ 4 , 6 , 17 ]. According to the number and size of the cysts contained, the pathological types included macrocystic-type (single or multilocular, ≥ 1 cm), microcystic-type (single or multilocular, < 1 cm) and mixed cystic-type (multilocular) [ 18 , 19 ].…”

“…Both ML and OL are almost cystic lymphatic malformations, making it impossible to measure their specific length, width and height; thus, in our study, the size of the cysts refers to the length of the entire cyst that was obtained from surgical records for patients undergoing open surgery and from preoperative imaging findings for patients undergoing laparoscopic surgery. The ML and OL cysts could contain serous, chylous, or turbid fluid, including serosanguinous fluid caused by hemorrhage or infection of the cyst [ 6 , 11 ]. The choice of surgical approach for all the included patients depended on the surgeon’s preference, and surgical approaches included open surgery (including laparoscopic conversion to open surgery) and laparoscopic surgery (including laparoscopic-assisted surgery and robot-assisted surgery).…”

“…The reported incidence of mesenteric lymphatic malformations (ML) and omental lymphatic malformations (OL) is approximately 1/250,000–1/20,000 [ 3 – 5 ]. Considering that ML cysts are often inseparable from the mesentery and intestinal wall, surgical treatment may include ML excision with segmental bowel resection, so a multidisciplinary approach, including medications, sclerotherapy and surgical treatment, is increasingly recommended for the treatment of ML to achieve better results [ 6 – 8 ]. In contrast, OL cysts are less likely to adhere to neighboring viscera and are mainly found in the greater omentum [ 9 , 10 ].…”