Laparoscopic interventions in children with retroperitonial lymphatic malformations

Abstract

   Introduction. Lymphatic malformations (LM) is the developmental anomaly of lymphatic vessels which is formed at the stage of early embryogenesis. Intraabdominal and retroperitoneal LM are very rare and account for 4 % of all observed LM.   Purpose. To clarify the effectiveness of minimally invasive surgical interventions in children with abdominal LM.   Material and methods. Over a ten-year period, 15 children with retroperitoneal lymphangiomas , aged from 1 to 17, were operated on in our clinics. To clarify diagnosis, a comprehensive examination was performed: ultrasound, spiral computed tomography, magnetic resonance imaging of the abdominal cavity. Laparoscopic access was applied in all 15 cases for surgical intervention.   Results. In all cases, lymphatic malformations were diagnosed before surgery which was later confirmed at laparoscopy. Malformations were excised laparoscopically. In 2 patients, lymphangiomatous tissue was partially left at the site of the greatest fusion with renal and iliac vessels due to a high risk of their damage.   Conclusion. Endovideosurgical technologies in children with retroperitoneal LM may be used at any child’s age and at any size of retroperitoneal cystic formation since emptying the cystic cavity creates the necessary working space in the abdominal cavity. Such an approach minimizes surgical trauma, shortens surgical time and facilitates the postoperative period.