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Category: Volume 06 Issue 01 January 2018
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Title: Effectiveness of Intralesional Bleomycin Sclerotherapy for Lymphangioma in Children

Authors: Dr. Mudassar Fiaz, Dr. Adnan Bashir Bhatti, MD, Dr. Irfan ullah

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.03

Abstract

Introduction: Lymphangiomas are congenital lymphatic malformations. The treatment of choice is surgical excision, but it has a high rate of complications and recurrences. Many investigators have assessed numerous alternative approaches. Local injection of bleomycin has been found to be an efficacious therapy without opting for surgery. This study assesses the effectiveness of Intralesional Bleomycin Sclerotherapy (IBS) in treating children for lymphangiomas, primarily in terms of reduction in size.

Methods: This prospective interventional study was conducted at the Pediatric Surgery Department, Children Hospital PIMS, Islamabad, from July 1st, 2013 to March 31st, 2014. Sixty children with cystic hygroma were included in this study. Bleomycin aqueous solution was injected into the lesion post-aspiration, and patients were hospitalized for 24 hours post-procedure. The final assessment was made after 3 months post-injection sclerotherapy with Bleomycin to see the effect on the size of the lesion.

Results: The average age of the studied patients was 35.3±25.4 months. There were 23 (38.3%) males and 37 (61.7%) females. The most frequent site was the neck in 38 (63.3%) children, other sites included face 8 (13.3%), axilla 8 (13.3%), and trunk 6 (10%). A single injection was effective in 3 (5%) patients, two injections were required in 21 (35%) and three injections were given in 36 (60%). Forty-three (71.7%) patients showed an excellent response, 12 (20%) patients showed a good response, and 5 (8.3%) showed a poor response to intralesional Bleomycin sclerotherapy.

Conclusion: Intralesional injection of bleomycin in children with lymphangioma is an effective method of achieving excellent to good results in more than 90% patients over three months.

Keywords: lymphangioma, cystic hygroma, bleomycin, sclerotherapy.

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Corresponding Author

Dr Adnan Bashir Bhatti, MD

Department of Neonatal & Paediatric Surgery,

Children Hospital PIMS, Islamabad, Pakistan

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