Barlas ETENSEL, Sezen ÖZKISACIK, Günyüz TEMİR, Aytaç KARKINER, Yeşim EDİRNE, Mesut YAZICI, İrfan KARACA, Harun GÜRSOY

ÇOCUKLARDA LENFANJİOM TEDAVİSİNDE OK-432 KULLANIMI SONUÇLARIMIZ

Amaç:Lenfanjiomlarda önceki yıllarda tedavinin temeli cerrahi rezeksiyondu fakat belirgin yara izi, yükseknüks ve organ hasarları gibi önemli komplikasyonlarla karşılaşılıyordu. Son yıllarda alternatif tedavi olaraksklerozan madde OK-432 kullanımı ön plandadır. İki ayrı çocuk cerrahisi merkezinde OK-432 skleroterapisiile tedavi gören olgu serimizi sunuyoruz.Hastalar ve yöntem:1999-2004 yılları arasında iki ayrı çocuk cerrahisi merkezinde OK-432 enjeksiyonu iletedavi gören olguların dosyaları geriye dönük olarak incelendi.Bulgular:5 yıllık bu dönemde 8 çocuk OK-432 ile skleroterapi uygulanarak tedavi edildi. 6 çocukta servikalbölgede, bir çocukta aksilla ve bir çocukta inguinal bölgede lenfanjiom saptandı. Olgularımıza ortalama 3enjeksiyon uygulandı. OK-432 uygulaması sırasında en büyük kistin saptanması, aspirasyon ve enjeksiyoniçin ultrasonografiden faydalanıldı. Makrokistik lezyonlarda başarı yüz güldürücü iken mikrokistik ve miksyapılı lezyonlarda başarı düşüktü.Sonuç:OK-432 ile skleroterapi lenfanjiomlarda özellikle makrokistik olanlarda güvenilir ve etkili bir tedaviyöntemidir. OK-432 tam yanıt alınamayan olgularda lezyon çevresinde fibrozis yaratmadığı için daha sonrayapılacak olan cerrahi işlemi güçleştirmemektedir

Anahtar Kelimeler:

çocuk, lenfanjiom, skleroterapi, OK-432

OK-432 Treatment Results of Lymphangiomas in Children

Objective: Surgery has previously been the mainstay of treatment for lymphangiomas but has attendant problems of marked scarring, high chance of recurrence and potential tissue damage. In recent years alternative management for these lesions involves the intralesional injection of OK-432. We present our series of lymphangiomas treated in two different pediatric surgery centers with OK-432 sclerotheraphy. Patients and method: A retrospective chart review was carried out of children undergoing intralesional OK-432 therapy from two Pediatric Surgery Centers between the years 1999-2004. Results: Eight children underwent OK-432 therapy requiring mean three injections each. Six children had lesions involving in the neck, one involved axilla and one child had an inguinal lesion. Ultrasound was used to localize the major cyst for aspiration and injection. Macrocystic lesions responded well to OK-432 therapy but the response of microcystic or mixed lesions to OK-432 was disappointing. Conclusion: OK-432 appears to be a safe and effective treatment for lymphangiomas especially the macrocystic ones. Another advantage of OK-432 is absence of sclerosis or fibrosis outside the cyst in cases where surgery is later required.

Keywords:

child, lymphangioma, sclerotheraphy, OK-432,

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