title: Cross-sectional study comparing different therapeutic modalities for cystic lymphangiomas in children.
abstract: OBJECTIVE
  Here, we describe our experience with different therapeutic modalities used to treat cystic lymphangiomas in children in our hospital, including single therapy with OK-432, bleomycin and surgery, and a combination of the three modalities.
  
  
  METHODS
  We performed a retrospective, cross-sectional study including patients treated from 1998 to 2011. The effects on macrocystic lymphangiomas and adverse reactions were evaluated. Twenty-nine children with cystic lymphangiomas without any previous treatment were included. Under general anesthesia, patients given sclerosing agents underwent puncture of the lesion (guided by ultrasound when necessary) and complete aspiration of the intralesional liquid. The patients were evaluated with ultrasound and clinical examinations for a maximum follow-up time of 4 years.
  
  
  RESULTS
  The proportions of patients considered cured after the first therapeutic approach were 44% in the surgery group, 29% in the bleomycin group and 31% in the OK-432 group. These proportions were not significantly different. Sequential treatment increased the rates of curative results to 71%, 74% and 44%, respectively, after the final treatment, which in our case was approximately 1.5 applications per patient.
  
  
  CONCLUSIONS
  The results of this study indicate that most patients with cystic lymphangiomas do not show complete resolution after the initial therapy, regardless of whether the therapy is surgical or involves the use of sclerosing agents. To achieve complete resolution of the lesions, either multiple operations or a combination of surgery and sclerotherapy must be used and should be tailored to the characteristics of each patient.
authors.affiliation: Campinas State University (UNICAMP), Surgery, Campinas/SP, Brazil.
authors.forename: Hugo de Oliveira
authors.initials: Hde O
authors.lastname: Olímpio
authors.affiliation: Campinas State University (UNICAMP), Pediatric Surgery, Campinas/SP, Brazil.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Bustorff-Silva
authors.affiliation: Campinas State University (UNICAMP), Pediatric Surgery, Campinas/SP, Brazil.
authors.forename: Antonio Gonçalves de
authors.initials: AG
authors.lastname: Oliveira Filho
authors.affiliation: Campinas State University (UNICAMP), Radiology, Campinas/SP, Brazil.
authors.forename: Kleber Cursino de
authors.initials: KC
authors.lastname: Araujo
mesh_terms: D001761:Bleomycin / Q000627:therapeutic use*; D001938:Brazil; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D018191:Lymphangioma, Cystic / Q000628:therapy*; D008297:Male; D010844:Picibanil / Q000627:therapeutic use*; D011677:Punctures / Q000379:methods*; D012074:Remission Induction; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D012597:Sclerosing Solutions; D001761:Bleomycin; D010844:Picibanil