Short-term Postoperative Complications of Lymphatic Malformation Surgical Excision: A 20-Year Institutional Review

Objective

To evaluate outcomes and postoperative complications following surgical resection of lymphatic malformations (LMs) at a single multidisciplinary vascular anomalies center.

Methods

A single-center retrospective review of all patients ≤21 years old who underwent surgical resection of a lymphatic malformation at a quaternary referral center with a multidisciplinary vascular anomalies team from 2004 to 2024. Data pertaining to postoperative outcomes and treatments was abstracted.

Results

A total of 109 surgical procedures were included and examined. The most common 30-day postoperative complications included: seroma (18.3 %), superficial surgical site infection (18.3 %), and wound dehiscence (12.8 %), with lower rates of nerve palsy/injury (5.5 %), lymphedema (2.8 %), hematomas (3.7 %), and abscesses (4.6 %). An interventional radiology procedure within 30-days postoperatively was required for management of seroma in 8 patients (7.3 %), while 7 (6.4 %) patients required reoperation. Among patients who underwent attempted complete resection, recurrence of the LM was documented in 32.0 % (16/50). Subjective quality of life improvement was noted in 69.7 %. There was no difference in incidence of postoperative complications reported in patients who underwent preoperative sclerotherapy vs those that did not (p = 0.980).

Conclusion

Seroma and surgical site infection were the most reported short-term postoperative complications followed by wound dehiscence with low rates of other complications in surgical resection of LMs. Few patients required postoperative procedural intervention. Despite a relatively high rate of short-term complications, patients reported high satisfaction and symptom improvement following LM resection, which underscores the important role for surgical management of LMs in select patients.

Level of evidence

III.

Type of study

Cohort study.