Simultaneous intra-operative sclerotherapy and surgical resection of cervicofacial venous malformations
Autor: | Carol J. MacArthur, Gary M. Nesbit |
---|---|
Rok vydání: | 2019 |
Předmět: |
Adult
Male Operating Rooms medicine.medical_specialty Adolescent Vascular Malformations medicine.medical_treatment Operative Time Radiology Interventional Veins Sodium Tetradecyl Sulfate Hemangioma Bleomycin 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Sclerotherapy medicine Humans Birthmark Child 030223 otorhinolaryngology Retrospective Studies Ethanol medicine.diagnostic_test business.industry Interventional radiology General Medicine Debulking medicine.disease Sclerosing Solutions Sodium tetradecyl sulfate Surgery Treatment Outcome Otorhinolaryngology Child Preschool Face Pediatrics Perinatology and Child Health Anesthetic Female business Venous malformation Neck medicine.drug |
Zdroj: | International Journal of Pediatric Otorhinolaryngology. 118:143-146 |
ISSN: | 0165-5876 |
Popis: | Objectives To review simultaneous intra-operative sclerotherapy (IOS) with immediate surgical resection for the treatment of cervicofacial venous malformations (VMs) at a single institution. While pre-operative sclerotherapy (POS) has been reported in the literature, simultaneous intra-operative sclerotherapy and surgery in the operating room has not. Methods The database from the Hemangioma and Vascular Birthmarks Clinic was reviewed. All patients in both groups had biopsy-proven VMs. Results IOS was used in 11 surgical patients with average age 17 years. Sclerotherapy was performed with sodium tetradecyl sulfate 3%, absolute alcohol or bleomycin. Immediately after IOS, and under the same anesthetic, all patients had either complete resection or debulking of the VMs. Eight patients had complete resolution of their VM and 3 had improvement. Average duration of the combined procedures done under a single anesthetic was 121 min. The POS approach was used for 6 surgical patients with average age 7 years. Sclerotherapy agents used were absolute alcohol or sodium tetradecyl sulfate 3%. All patients underwent complete resection of the VM 24–72 h after sclerotherapy under a separate surgical session. Five patients experienced complete resolution of their VM and one has had further sclerotherapy for recurrent disease. Interventional Radiology suite sclerotherapy times were on average 70 min. Surgical times were on average 142 min. Total combined anesthesia times for the two procedures added together were 212 min. Treatment time was significantly shorter in the IOS group (p = 0.0015). Conclusions Simultaneous IOS at the time of surgical resection has been successful in our hands. IOS has the advantage of a single procedure and decreased cost to the patient. In the era of reducing pediatric exposure to anesthesia, this approach is especially attractive in the pediatric population. As well, at approximately $100/minute cost to the patient to be in either the Interventional Radiology Suite or in the operating room, the reduced length of the procedures seen in the IOS approach results in lower overall cost to the patient. |
Databáze: | OpenAIRE |
Externí odkaz: |