Lymphangiomas in children

Forty-one patients presented with a diagnosis of lymphangioma to the Department of Pediatric Surgery between 1971-1995 and 36 of them were treated. The distribution of lymphangiomas was: cervical (41.5 %), trunk (17.1 %), craniofacial (14.6 %), intraabdominal (7.3 %), axillar (7.3 %), extremity (4.9 %), cevicoaxillothoracic (2.4 %) and cervicoaxillar (2.4 %). Of 36 patients undergoing primary therapy, total excision was performed in 77.8 % and partial excision in 16.7 % with recurrence rates of 3.6 % and 83.3 %, respectively. Only two patients required drainage alone without clinical recurrence. Resection for residual or recurrent disease accounted 11.4 % (5/44) of all operations. The postoperative complication rate was 29.5 %. Seroma was the leading complication with an incidence of 38.4 %. Neither drains nor antibiotics were found to be effective in preventing the occurrence of complications. The results of pathological examinations of this series were: cystic lymphangioma (55.9 %), simple lymphangioma (32.3 %), lymphohemangioma (8.8 %), cavernous lymphangioma (2.9 %). The overall mortality rate was 4.9 %. Only one patient was lost in the operative group due to pseudomonas sepsis. The mainstay of therapy for lymphangiomas is still complete resection of tumoral mass without compromising vital structures. It appears that local drains and perioperative antibiotics do not diminish postoperative complications