Effect analysis of lauromacrogol foam injection under ultrasonic guidance for pediatric superficial lymphatic malformation

Abstract

Abstract Objective To evaluate the efficacy and safety of ultrasound guided lauromacrogol foam sclerotherapy in the treatment of children’s superficial lymphatic malformation. Methods Retrospectively analyzing 64 pediatric patients (36 male, 28 female), aged 3 months to 14 years, who underwent lauromacrogol foam sclerotherapy with ultrasonic guidance for superficial lymphatic malformation at Hunan Children's Hospital from March 2018 to November 2022, the study grouped patients into 18 macrocystic, 40 microcystic, and 6 mixed types. Pre-sclerotherapy evaluations included local ultrasound, blood routine, liver and kidney function, and coagulation tests. The surface anesthetic lidocaine cream was applied 30 minutes prior, followed by ultrasound-guided lymphatic malformation area localization, cyst fluid extraction, and lauromacrogol foam injection (lauromacrogol: air = 1:3; single dose < 20 ml) to fill the cyst cavity, with retention of the lauromacrogol stock solution (< 2 ml). Assessing drug dispersion in the cyst cavity via ultrasound and confirming high-echo gas filling, the follow-up period ranged from 3 to 12 months, with evaluations on clinical manifestations, imaging data, treatment efficacy, and complications. Results The children received treatment 2-6 times, with an average of 4 treatments per case. A total of thirty-three cases(51.56%) achieved complete remission, while twenty-eight(43.75%) cases showed significant improvement. Three cases failed to respond and subsequently underwent surgical resection. The overall efficacy rate was determined to be 95.31%. Early edema occurred in five cases, localized skin pigmentation in one case, thrombotic superficial vein inflammation in two cases, and transient cough in one case. None of the children experienced serious complications such as allergic reactions, deep vein thrombosis or pulmonary embolism, skin necrosis or discoloration, chest tightness or other cardiopulmonary issues. Conclusions The utilization of ultrasound-guided foam sclerotherapy with lauromacrogol represents a secure and efficacious approach for managing lymphatic malformations in pediatric patients.