WOFAPS 2025 8th World Congress of Pediatric Surgery

Dinar Safin, Yurii Polyaev, Roman Garbuzov, Anton Narbutov, Andrei Mylnikov, Ivan Mylnikov

Russian Children's Clinical Hospital

Lymphatic malformation (LM) is a congenital disorder affecting the lymphatic system, caused by spontaneous gene mutations during fetal development. The International Society for the Study of Vascular Anomalies classifies LM into three main types: macro cystic, micro cystic, and mixed forms.

The primary treatment for LM is sclerotherapy, which involves injecting various drugs such as bleomycin, OK-432, doxycycline, or alcohol into the affected lymphatic cavities. These substances damage the endothelium, trigger an inflammatory response, and eventually close the cavity. The advantages of this method include minimal trauma, the ability to perform the procedure under local anesthesia, and high patient tolerance. However, it has limitations, such as the need for repeated sessions, ineffectiveness in small cysts, and difficulty in accessing certain areas.

In Russia, the drug “Lymphoblock” has been developed. It contains a polyacrylic acid salt with silver nanoparticles. When injected, it forms a polyacrylic matrix that interacts with proteins and is eventually replaced by fibrin, achieving a sclerosing effect.

Our study aimed to evaluate the use of “Lymphoblock” in treating macro cystic and mixed lymphatic malformations in children. We enrolled five patients treated at our clinic from June 2022 to December 2022, with a follow-up period of 2.5 years.

During the early postoperative period, all patients experienced soft tissue edema and pain, which lasted 5-10 days and began 20-60 minutes after sclerotherapy, respectively.

After one year of follow-up, three patients showed complete resolution of the malformation. One patient retained minor cavities that did not require further treatment. Another patient experienced a 30-40% reduction in cavity size and underwent an additional sclerotherapy session.

The study demonstrated promising results with minimal side effects, making “Lymphoblock” a viable sclerosant for treating LM in children.