Journal article
Management and Outcomes of Pediatric Lymphatic Malformations: A Systematic Review From the APSA Outcomes and Evidence-Based Practice Committee
Journal of pediatric surgery, v 59(10), 161589
01 Oct 2024
PMID: 38914511
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Significant variation in management strategies for lymphatic malformations (LMs) in children persists. The goal of this systematic review is to summarize outcomes for medical therapy, sclerotherapy, and surgery, and to provide evidence-based recommendations regarding the treatment. Methods: Three questions regarding LM management were generated according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Publicly available databases were queried to identify articles published from January 1, 1990, to December 31, 2021. A consensus statement of recommendations was generated in response to each question. Results: The initial search identified 9326 abstracts, each reviewed by two authors. A total of 600 abstracts met selection criteria for full manuscript review with 202 subsequently utilized for extraction of data. Medical therapy, such as sirolimus, can be used as an adjunct with percutaneous treatments or surgery, or for extensive LM. Sclerotherapy can achieve partial or complete response in over 90% of patients and is most effective for macrocystic lesions. Depending on the size, extent, and location of the malformation, surgery can be considered. Conclusion: Evidence supporting best practices for the safety and effectiveness of management for LMs is currently of moderate quality. Many patients benefit from multi-modal treatment determined by the extent and type of LM. A multidisciplinary approach is recommended to determine the optimal individualized treatment for each patient. Level of evidence: 4.
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Details
- Title
- Management and Outcomes of Pediatric Lymphatic Malformations: A Systematic Review From the APSA Outcomes and Evidence-Based Practice Committee
- Creators
- Carlos Theodore Huerta - University of MiamiAlana L. Beres - Drexel UniversityBrian R. Englum - University of Maryland, BaltimoreKatherine Gonzalez - St. Luke's Children's HospitalTamar Levene - Joe DiMaggio Children's HospitalDerek Wakeman - University of RochesterYasmine Yousef - Joe DiMaggio Children's HospitalBrian C. Gulack - Rush University Medical CenterHenry L. Chang - Johns Hopkins All Children's HospitalEmily R. Christison-Lagay - Yale New Haven HospitalPhillip Benson Ham III - University at Buffalo, State University of New YorkSara A. Mansfield - Nationwide Children's HospitalAfif N. Kulaylat - Penn State Milton S. Hershey Medical CenterDonald J. Lucas - Uniformed Services University of the Health SciencesRebecca M. Rentea - Children's Mercy HospitalChristopher P. Pennell - Mercy HospitalJason P. Sulkowski - Children's Hospital of Richmond at VCUKatie W. Russell - University of UtahRobert L. Ricca - University of South CarolinaLorraine I. Kelley-Quon - University of Southern CaliforniaJun Tashiro - NYU Langone Hlth, Hassenfeld Childrens Hosp, Div Pediat Surg, New York, NY USAKristy L. Rialon - Baylor College of MedicineAmer Pediat Surgical Assoc
- Publication Details
- Journal of pediatric surgery, v 59(10), 161589
- Publisher
- Elsevier
- Number of pages
- 13
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics; Surgery
- Web of Science ID
- WOS:001317264500001
- Scopus ID
- 2-s2.0-85196717891
- Other Identifier
- 991021969587904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics
- Surgery