Lymphatic malformations adjacent to the airway in neonates: Risk factors for outcome

Autor: Sanne M. B. I. Botden, Willemijn M. Klein, Ivo de Blaauw, Mallory Woiski, Bas H. Verhoeven, Frédérique C.M. Bouwman
Rok vydání: 2021
Předmět:
medicine.medical_specialty
medicine.medical_treatment
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
Sepsis
03 medical and health sciences
0302 clinical medicine
Risk Factors
030225 pediatrics
Sclerotherapy
Medicine
Humans
Lymphatic malformations
Retrospective Studies
Lymphatic Abnormalities
business.industry
Other Research Radboud Institute for Health Sciences [Radboudumc 0]
Infant
Newborn
General Medicine
Debulking
medicine.disease
Surgery
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10]
Airway Compromise
Exact test
Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10]
Lymphatic system
Treatment Outcome
030220 oncology & carcinogenesis
Pediatrics
Perinatology and Child Health
business
Airway
Zdroj: Journal of Pediatric Surgery, 56, 1764-1770
Journal of Pediatric Surgery, 56, 10, pp. 1764-1770
ISSN: 0022-3468
Popis: Contains fulltext : 238665.pdf (Publisher’s version ) (Open Access) PURPOSE: To evaluate imaging, treatment, and outcomes in neonates with a lymphatic malformation (LM) adjacent to the airway and to evaluate risk factors that can predict outcome. METHODS: A retrospective case series was conducted of ten patients treated between January 2011 and July 2019. The main outcome measures included airway compromise and clinical response to sclerotherapy +/- surgery. Categorical data were compared using the Fisher's exact test. RESULTS: Ex-utero intrapartum therapy was performed in four cases, among whom one died due to sepsis. All patients underwent schlerotherapy, with surgical debulking in two. Four patients showed a good clinical response, and five started experimental systemic treatment. Patients with bilateral disease and patients with an LM with >180 degrees tracheal surrounding were significantly at risk for airway compromise (bilateral: n = 6/6 versus n = 0/4, p = 0.005; >180 degrees : n = 5/5 versus n = 1/5, p = 0.048). The need for LM treatment in the neonatal period was indicative of a poor clinical response ('non-responders' 5/6, 'responders' 0/4; p = 0.048). CONCLUSIONS: This study indicates that bilateral disease and >180 degrees tracheal surrounding are risk factors for airway compromise in neonates with an LM adjacent to the airway. In addition, the need for early treatment seems to be indicative of a poor clinical response.
Databáze: OpenAIRE
Externí odkaz: