Sclerotherapy for lymphatic malformations in children: a scoping review
Sclerotherapy for lymphatic malformations in children: a scoping review
复制标题
DOI：
10.1016/j.jpedsurg.2011.02.027
复制
发表时间：
2011-05-01
影响因子：
2.4
通讯作者：
Walton, J. Mark
中科院分区：
文献类型：
--
作者：
Churchill, Paige;Otal, Damanjot;Walton, J. Mark
目的：对硬化剂治疗儿童淋巴管畸形的文献进行综述，总结目前硬化剂治疗儿童淋巴管畸形的证据。方法：利用多个数据库对已发表和未发表的文献进行全面检索。标题、摘要和全文筛选由2名独立的临床医生进行。结果：共检索到182篇文献。44篇文章被删除为重复，11篇文章在回顾重要研究后增加。经过全文摘要，最终结果纳入44篇文章和2个会议论文集(N=882名患者)。12篇文章被归类为II级证据，34篇文章归类为IV级证据。Picibanil(OK-432)是大多数纳入研究中使用的主要药物。注射OK-432后的症状主要是发烧、肿胀和部位红斑。危及生命的并发症并不常见，包括注射后宫颈病变肿胀导致呼吸道损害。结论：关于淋巴畸形硬化治疗的文献证据较少，且缺乏标准化。将重点放在OK-432、博莱霉素或玉米醇溶蛋白酒精溶液上的随机临床试验；标准化的剂量方案；以及一致和可靠的结果报告将是进一步制定治疗指南所必需的。(C)2011 Elsevier Inc.保留所有权利。
Purpose: This scoping review assesses the literature and summarizes the current evidence on sclerotherapy for the treatment of lymphatic malformations in pediatric patients.Methods: A comprehensive search of published and unpublished literature was conducted using multiple databases. Title, abstract, and full-text screening was conducted by 2 independent clinicians. All discrepancies were resolved during consensus meetings.Results: A total of 182 articles were retrieved. Forty-four articles were removed as duplicates, and 11 articles were added after reviewing prominent studies. After full-text abstraction, 44 articles and 2 conference proceedings (N = 882 patients) were included in the final results. Twelve articles were classified as level II and 34 articles as level IV evidence. Picibanil (OK-432) was the primary agent used in most included studies. Postinjection symptoms with OK-432 were primarily fever, swelling, and erythema at the site. Life-threatening complications were uncommon and involved postinjection swelling of cervical lesions causing airway compromise.Conclusions: The literature regarding sclerotherapy for lymphatic malformations is of a low level of evidence and suffers from a lack of standardization. Randomized clinical trials focused on OK-432, bleomycin, or alcoholic solution of zein; standardized dosing protocols; and consistent and reliable outcome reporting will be necessary for further development of treatment guidelines. (C) 2011 Elsevier Inc. All rights reserved.