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Surgery Today
Published in: Surgery Today 7/2018

01-07-2018 | Original Article

Treatment of mediastinal lymphatic malformation in children: an analysis of a nationwide survey in Japan

Authors: Shigeru Ueno, Akihiro Fujino, Yasuhide Morikawa, Tadashi Iwanaka, Yoshiaki Kinoshita, Michio Ozeki, Shunsuke Nosaka, Kentaro Matsuoka, Noriaki Usui

Published in: Surgery Today | Issue 7/2018

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Abstract

Purpose

Clinical guidelines on lymphatic malformation (LM) influencing the airway have been crafted in the Research Project for Intractable Diseases. We herein report an analysis of a nationwide survey of mediastinal LM and the therapeutic recommendations.

Methods

Eighty-seven registered cases with mediastinal involvement were analyzed with a review of the literature.

Results

Mediastinal LM was located more often in the upper and anterior mediastinum and was found without any accompanying symptoms in 56/87 cases. Tracheostomy was required in 23/87 cases, mostly < 2 years of age (87%). All patients who needed tracheostomy had a lesion in contact with the airway, while only 55% of those without tracheostomy had contact. Tracheostomy tended to be placed more when the longer segment of the airway was in contact with the LM. Multimodal treatments were performed in 29 patients, but the lesions remained in most cases, and chylothorax, hemorrhaging, nerve palsy, and infections were noted as complications.

Conclusions

In patients with mediastinal LM, tracheostomy may be necessary, especially when the lesion is extensive and contacts the airway. Extirpation of the mediastinal LM may be the only therapeutic option, but in cases with few or no symptoms, non-surgical treatment should be considered in light of potential postoperative complications.
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Metadata
Title
Treatment of mediastinal lymphatic malformation in children: an analysis of a nationwide survey in Japan
Authors
Shigeru Ueno
Akihiro Fujino
Yasuhide Morikawa
Tadashi Iwanaka
Yoshiaki Kinoshita
Michio Ozeki
Shunsuke Nosaka
Kentaro Matsuoka
Noriaki Usui
Publication date
01-07-2018
Publisher
Springer Singapore
Published in
Surgery Today / Issue 7/2018
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-018-1640-0

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