دورية أكاديمية
Surgical Management of Vascular Malformations of the Upper Extremity: A 12-Year Retrospective Cohort Study.
العنوان: | Surgical Management of Vascular Malformations of the Upper Extremity: A 12-Year Retrospective Cohort Study. |
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المؤلفون: | Hu S; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA., Muss TE; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA., Toyoda Y; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA., Kim MS; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA., Chang AE; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA., Banala M; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA., Graham EM; Department of Plastic Surgery, University of Michigan, Ann Arbor, MI., Gunturi D; Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA., Lin IC; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA. |
المصدر: | Annals of plastic surgery [Ann Plast Surg] 2024 Apr 01; Vol. 92 (4S Suppl 2), pp. S132-S135. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Little, Brown And Company Country of Publication: United States NLM ID: 7805336 Publication Model: Print Cited Medium: Internet ISSN: 1536-3708 (Electronic) Linking ISSN: 01487043 NLM ISO Abbreviation: Ann Plast Surg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Boston Ma : Little, Brown And Company Original Publication: Boston, Little, Brown. |
مواضيع طبية MeSH: | Veins*/surgery , Vascular Malformations*/surgery, Child ; Infant, Newborn ; Humans ; Male ; Child, Preschool ; Female ; Retrospective Studies ; Sclerotherapy/methods ; Hand ; Treatment Outcome |
مستخلص: | Introduction: Vascular malformations (VMs) typically appear at birth and grow commensurately with patients. They can vary broadly in vessel type and tissue involvement, and upper extremity (UE) VMs can pose unique functional and aesthetic challenges in children. Given the advent of operative and nonoperative technologies like sclerotherapy and medications, a contemporary review of the surgical management of UE VMs is warranted. Methods: We performed a retrospective review of all patients who had surgical management of VMs from 2010 to 2021 at The Children's Hospital of Philadelphia. Demographics, lesion characteristics, treatment (including preceding nonsurgical therapies), complications, and final outcomes were recorded. Operative notes were reviewed for date of operation, depth of excision, type of closure, and current procedural terminology code. Results: Sixty-seven patients with 88 procedures were studied. Average patient age was 5.8 years, with 64% White and 67% male. Venous (34%) and lymphatic (19%) malformations were most common, and anatomic locations were most frequently on the hand (33%) and forearm (25%). The average lesion diameter was 4.2 cm, although this varied by location (eg, 2.9 cm, hand; 11.1 cm, chest wall). Fifty-eight patients (87%) underwent surgical excision as their index procedure, and 9 had sclerotherapy before surgery. Thirty-nine patients (60%) had subcutaneous excisions, and the remainder required subfascial or intramuscular excisions. Nearly all excisions were closed primarily (97%). Of the 53 patients with documented follow-up, 32 patients (60%) had complete resolution of their lesion as of their final visit. Thirty of these 32 patients with no clinical evidence of residual VM had only 1 surgery for excision. Conclusion: Upper extremity VMs were composed of diverse conditions with varying vessel types, size, depth, and anatomic sites. Surgical excision of VMs of the UE was safe and effective. A majority of VMs were fully excised after 1 procedure and frequently closed primarily with relatively low complication rates. Future work should investigate decision-making and outcomes of all treatment options of VMs of the UE for optimal functionality and aesthetics. Competing Interests: Conflicts of interest and source of funding: The authors have no conflicts of interest to declare. This research received no specific grant from any funding agency. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
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تواريخ الأحداث: | Date Created: 20240401 Date Completed: 20240402 Latest Revision: 20240402 |
رمز التحديث: | 20240402 |
DOI: | 10.1097/SAP.0000000000003852 |
PMID: | 38556661 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1536-3708 |
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DOI: | 10.1097/SAP.0000000000003852 |