Staged-Surgery for Vascular Malformations of the Extremities and the Trunk

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  • Fujino Junko
    Department of Pediatric Surgery, Dokkyo Medical University Koshigaya Hospital
  • Ishimaru Yuki
    Department of Pediatric Surgery, Dokkyo Medical University Koshigaya Hospital
  • Tahara Kazunori
    Department of Pediatric Surgery, Dokkyo Medical University Koshigaya Hospital
  • Suzuki Makoto
    Department of Pediatric Surgery, Dokkyo Medical University Koshigaya Hospital
  • Hatanaka Masahiro
    Department of Pediatric Surgery, Dokkyo Medical University Koshigaya Hospital
  • Igarashi Akihiro
    Department of Pediatric Surgery, Dokkyo Medical University Koshigaya Hospital
  • Hamajima Akito
    Department of Plastic Surgery, Gunma Children's Medical Center
  • Hasumi Toshiaki
    Department of Plastic Surgery, Funabashi Chuo Hospital
  • Ikeda Hitoshi
    Department of Pediatric Surgery, Dokkyo Medical University Koshigaya Hospital

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Other Title
  • 四肢,体幹の血管奇形(脈管性腫瘤)に対する多期手術の経験
  • 症例報告 四肢,体幹の血管奇形(脈管性腫瘤)に対する多期手術の経験
  • ショウレイ ホウコク シシ タイカン ノ ケッカン キケイ ミャクカンセイ シュリュウ ニ タイスル タキ シュジュツ ノ ケイケン

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Abstract

We report our experience of staged-surgery in patients with vascular malformations of the extremities and the trunk. Between April 2000 and March 2010, staged-surgery was performed in 4 patients with vascular malformations of the extremities and the trunk. There were 3 patients with lymphatic malformation (2 cavernous lymphangioma, 1 cystic lymphangioma) and one patient with arteriovenous malformation (AVM). In the patients with lymphangioma staged-surgery was performed after sclerotherapy with OK432, while it was performed after confirming that the lesion was not regressing in the patient with AVM. The staged-surgery was initially performed as partial resection which was followed by a second resection 1 to 3 years after the first surgery. OK432 sclerotherapy was combined during or after the first surgery in the patients with lymphangioma, but there was no additional treatment after the second surgery. During the follow-up of 19 months to 82 months, there were no recurrences or therapeutic complications. Local cosmetic results were excellent and satisfactory in 2 patients with lymphangioma. It was relatively good in the remaining 2 patients although the third surgery might be necessary. By performing staged-surgery while waiting for the patients' physical growth, injuries to local function can be avoided and excellent or good cosmetic results can be obtained in patients with vascular malformations of the extremities and the trunk.

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