Wu Qiang,Zhong Wei,Lyu Junjian,et al.Programmatic management of cervical lymphatic malformations with airway obstruction[J].Journal of Clinical Pediatric Surgery,,22():726-730.[doi:10.3760/cma.j.cn101785-202306043-005]
Programmatic management of cervical lymphatic malformations with airway obstruction
- Keywords:
- Lymphatic Malformations; Airway Obstruction; Programmed; Treatment; Prognosis
- Abstract:
- Objective To summarize the clinical experiences of managing cervical lymphatic malformation with airway obstruction(CLMAO) from prenatal assessments to postnatal interventions.Methods Retrospective analysis was conducted for clinical data of 22 hospitalized CLMAO infants from July 2015 to March 2023.Nine cases were born at our hospital while another 13 infants were transferred from other hospitals.They were assigned into two groups of early surgical treatment(n=6) and protocol treatment(n=16).Fetal assessments, intrapartum managements and postnatal interventions were recorded.Surgical complications, duration of mechanical ventilation, length of hospital stay and other prognostic factors were compared between two groups.Results Nine infants born at our hospital were examined by prenatal magnetic resonance imaging(MRI) for assessing tracheoesophageal displacement index(TEDI) or amniotic fluid volume.Eight infants had TEDI>12 mm or polyhydramnios.Ex-utero intrapartum treatment(EXIT) was offered for postnatal dyspnea.One case of TEDI ≤ 12 mm and normal amniotic fluid volume had dyspnea after umbilical cord clamping and underwent tracheal intubation.The accuracy of prenatal assessment for airway obstruction was 88.9%(8/9).Three cases were operated in protocol treatment group.As compared with early treatment group, no significant inter-group differences existed in proportion of tracheostomy, duration of mechanical ventilation or length of hospital stay.During a follow-up period of(6-39) months, there was no significant difference in cure rate or improvement rate. Conclusion Fetuses with suspected CLMAO should be evaluated for TEDI and amniotic fluid volume.As compared with early surgery, programmed therapy may obtain comparable outcomes.It offers a novel therapeutic option for CLMAO.
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Memo
收稿日期:2023-06-27。
基金项目:广州市基础研究计划-基础与应用基础研究项目（202102080511）
通讯作者:何秋明,Email:qiuminghe@foxmail.com