Low-flow vascular malformations of the hand and forearm: a multidisciplinary experience in a tertiary paediatric centre.

Autor: Karunaratne YG; Department of Paediatric Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia.; Department of Plastic and Reconstructive Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia., Greer D; Department of Paediatric Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia., Hong LH; School of Women's and Children's Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia., Somia N; Department of Plastic and Reconstructive Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia.; School of Women's and Children's Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia., Wargon O; School of Women's and Children's Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia.; Department of Dermatology, Sydney Children's Hospital, Sydney, New South Wales, Australia., Adams S; Department of Paediatric Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia.; School of Women's and Children's Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
Jazyk: angličtina
Zdroj: ANZ journal of surgery [ANZ J Surg] 2021 Sep; Vol. 91 (9), pp. 1739-1743. Date of Electronic Publication: 2021 Jan 21.
DOI: 10.1111/ans.16591
Abstrakt: Background: Vascular malformations (VMs) involving the hand and forearm in children provide management challenges due to complex anatomy, indispensable functionality and developmental implications.
Methods: The institution's Vascular Registry was searched for patients with hand and arm VMs, supplemented by chart review of included patients.
Results: Twenty-one patients were identified, 52% male, with mean presenting age 5.2 years. Venous malformations predominated (71%), followed by lymphatic-venous (19%), lymphatic (5%) and glomuvenous (5%). Symptoms included pain (76%), swelling (71%), cosmetic concerns (81%), functional compromise (29%) and stiffness (5%). Imaging modality was ultrasound (100%), and magnetic resonance imaging (71%). Treatment included compression (62%), sclerotherapy (62%) and surgery (24%). Post-sclerotherapy ultrasounds showed complete sclerosis (25%), near complete sclerosis (58%) and partial sclerosis (17%). Post-surgery, patients reported improved cosmesis (80%), size (100%), pain (60%) and function (40%). Complications occurred in 24%, including bleeding, digital ischaemia and thrombosis. Mean follow-up was 3.4 years.
Conclusion: Children with low-flow VMs of the hand and forearm experience significant symptoms and functional limitations. A multidisciplinary approach to management ensures optimal outcomes.
(© 2021 Royal Australasian College of Surgeons.)
Databáze: MEDLINE
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