Impact of Intracystic Hemorrhage on Therapeutic Outcomes in Macro/Mixed Cystic Lymphatic Malformation: A Retrospective Cohort Study

<b>Objectives</b>: This research aims to examine the impact of intracystic hemorrhage (ICH) on therapeutic outcomes in children with macro or mixed cystic lymphatic malformation (cLM). <b>Methods</b>: This retrospective study included macro/mixed cLM cases with or without ICH...

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Main Authors: Tao Han, Daolin Ye, Jie Cui, Songming Huang, Weimin Shen
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/7/935
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author Tao Han
Daolin Ye
Jie Cui
Songming Huang
Weimin Shen
author_facet Tao Han
Daolin Ye
Jie Cui
Songming Huang
Weimin Shen
author_sort Tao Han
collection DOAJ
description <b>Objectives</b>: This research aims to examine the impact of intracystic hemorrhage (ICH) on therapeutic outcomes in children with macro or mixed cystic lymphatic malformation (cLM). <b>Methods</b>: This retrospective study included macro/mixed cLM cases with or without ICH who underwent treatment between January 2019 and June 2024. All patients were diagnosed using preoperative imaging findings and intraoperative indocyanine green (ICG) lymphography. The baseline data of enrolled cases were retrospectively collected. The clinical characteristics were documented, including gender, age, histological typing, location, maximum diameter, and intracystic condition. Patients with or without ICH were divided into two groups. The dependent variables for predicting an excellent outcome were analyzed using multivariable logistic regression models after adjusting for potential factors using a univariable regression model. Postoperative variables, including duration of negative drainage, local infection, scar hyperplasia, and follow-up, were compared between the two groups. <b>Results</b>: A total of 83 cLM patients were included (ICH group: <i>n</i> = 36 and without ICH group: <i>n</i> = 47). A complete absence of afferent lymphatic vessels was demonstrated using intraoperative ICG lymphography, suggesting the isolated nature of ICH cases. ICH (<i>p</i> = 031; OR, 2.560; 95% CI, 1.089–6.020) was identified as the main predictor, and younger patients (<i>p</i> = 035; OR, 0.415; 95% CI, 0.183–0.940) had a lower potential for excellent outcomes. For the postoperative variables, the ICH group exhibited a shorter duration of negative drainage than the without ICH group (<i>p</i> < 0.001), while no significant differences were found regarding local infection (<i>p</i> = 0.693) and scar hypertrophy (<i>p</i> = 0.648). <b>Conclusions</b>: Although characterized by aggressive progression and compressive symptoms, ICH emerges as an independent favorable prognostic predictor in macro/mixed cLM management, potentially attributable to its isolated nature.
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spelling doaj-art-88d26026ab7d438a9a02117d60fb0e8a2025-08-20T02:45:54ZengMDPI AGChildren2227-90672025-07-0112793510.3390/children12070935Impact of Intracystic Hemorrhage on Therapeutic Outcomes in Macro/Mixed Cystic Lymphatic Malformation: A Retrospective Cohort StudyTao Han0Daolin Ye1Jie Cui2Songming Huang3Weimin Shen4Department of Burns and Plastic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing 210008, ChinaDepartment of Burns and Plastic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing 210008, ChinaDepartment of Burns and Plastic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing 210008, ChinaDepartment of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing 210008, ChinaDepartment of Burns and Plastic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing 210008, China<b>Objectives</b>: This research aims to examine the impact of intracystic hemorrhage (ICH) on therapeutic outcomes in children with macro or mixed cystic lymphatic malformation (cLM). <b>Methods</b>: This retrospective study included macro/mixed cLM cases with or without ICH who underwent treatment between January 2019 and June 2024. All patients were diagnosed using preoperative imaging findings and intraoperative indocyanine green (ICG) lymphography. The baseline data of enrolled cases were retrospectively collected. The clinical characteristics were documented, including gender, age, histological typing, location, maximum diameter, and intracystic condition. Patients with or without ICH were divided into two groups. The dependent variables for predicting an excellent outcome were analyzed using multivariable logistic regression models after adjusting for potential factors using a univariable regression model. Postoperative variables, including duration of negative drainage, local infection, scar hyperplasia, and follow-up, were compared between the two groups. <b>Results</b>: A total of 83 cLM patients were included (ICH group: <i>n</i> = 36 and without ICH group: <i>n</i> = 47). A complete absence of afferent lymphatic vessels was demonstrated using intraoperative ICG lymphography, suggesting the isolated nature of ICH cases. ICH (<i>p</i> = 031; OR, 2.560; 95% CI, 1.089–6.020) was identified as the main predictor, and younger patients (<i>p</i> = 035; OR, 0.415; 95% CI, 0.183–0.940) had a lower potential for excellent outcomes. For the postoperative variables, the ICH group exhibited a shorter duration of negative drainage than the without ICH group (<i>p</i> < 0.001), while no significant differences were found regarding local infection (<i>p</i> = 0.693) and scar hypertrophy (<i>p</i> = 0.648). <b>Conclusions</b>: Although characterized by aggressive progression and compressive symptoms, ICH emerges as an independent favorable prognostic predictor in macro/mixed cLM management, potentially attributable to its isolated nature.https://www.mdpi.com/2227-9067/12/7/935intracystic hemorrhagecystic lymphatic malformationindocyanine greentherapeutic outcomeschildren
spellingShingle Tao Han
Daolin Ye
Jie Cui
Songming Huang
Weimin Shen
Impact of Intracystic Hemorrhage on Therapeutic Outcomes in Macro/Mixed Cystic Lymphatic Malformation: A Retrospective Cohort Study
Children
intracystic hemorrhage
cystic lymphatic malformation
indocyanine green
therapeutic outcomes
children
title Impact of Intracystic Hemorrhage on Therapeutic Outcomes in Macro/Mixed Cystic Lymphatic Malformation: A Retrospective Cohort Study
title_full Impact of Intracystic Hemorrhage on Therapeutic Outcomes in Macro/Mixed Cystic Lymphatic Malformation: A Retrospective Cohort Study
title_fullStr Impact of Intracystic Hemorrhage on Therapeutic Outcomes in Macro/Mixed Cystic Lymphatic Malformation: A Retrospective Cohort Study
title_full_unstemmed Impact of Intracystic Hemorrhage on Therapeutic Outcomes in Macro/Mixed Cystic Lymphatic Malformation: A Retrospective Cohort Study
title_short Impact of Intracystic Hemorrhage on Therapeutic Outcomes in Macro/Mixed Cystic Lymphatic Malformation: A Retrospective Cohort Study
title_sort impact of intracystic hemorrhage on therapeutic outcomes in macro mixed cystic lymphatic malformation a retrospective cohort study
topic intracystic hemorrhage
cystic lymphatic malformation
indocyanine green
therapeutic outcomes
children
url https://www.mdpi.com/2227-9067/12/7/935
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