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Year 2021 Vol. 29 No 3

GENERAL & SPECIAL SURGERY

V.F. RYBALCHENKO 1, A.A. PEREYASLOV 2, I.G. RYBALCHENKO 3, O.M. NYKYFORUK 2

STRATEGY AND EXPERIENCE OF INFANTILE HEMANGIOMA TREATMENT

P.L.Shupyk National Academy of Postgraduate Education, Kiev, Ukraine,
Danylo Halytsky Lviv National Medical University, Lviv, Ukraine,
National Children Specialized Hospital «OXMATDYT», Kiev, Ukraine

Objective. To analyze the treatment results of patients with infantile hemangiomas using various methods.
Methods. The study is grounded on the treatment results of children (n=189) with infantile hemangiomas during the period of 2000-2018 years. All patients were divided into the groups: 1) dynamic observation – 23 (12.2%) children; 2) local destruction – 78 (41.3%); 3) surgical treatment – 22 (11.6%); 4) drug therapy – 66 (34.9%) patients. The interstitial coagulation (n=28) and electrocoagulation of hemangioma (n=50) were applied for the local destruction. 18 patients underwent the complete removal of hemangioma and 4 - segmental resection of tumor with the subsequent propranolol treatment. Propranolol was used for the drug treatment and it was combined with the topical application of timolol (n=13).
Results. Hemangioma regression was registered in 18 (78.3%) patients of the first group. Among the patients of the second group, involution of hemangioma was observed in 26 (92.6%) patients when the interstitial coagulation was applied and 2 (7.4%) children had hemangioma recurrence.
A strong positive effect can be reached by electrocoagulation of superficial hemangiomas (all patients). With primary radical intervention, complete cure was noted in all children, and with segmental resection only one (4.5%) child had a relapse. Keloid scars were formed in 3 (13.6%) children after surgery. Propranolol seemed to be effective in treating hemangiomas in children of all ages, and in 41 (62.1%) patients hemangiomas completely disappeared.
Conclusion. Before initiating therapy, the children need to be assessed for the contraindications and the treatment strategy. In case of infantile hemangioma should be individual based on the results of clinical investigation. Systemic propranolol treatment has gained rapid popularity as the treatment of choice for infantile hemangiomas and may be applied not only as the basic treatment, but also in combination with other methods. Surgical removal of hemangioma remains one of the common treatments components for children with infantile hemangiomas.

Keywords: children, infantile hemangioma, treatment, propranolol, surgery
p. 296-301 of the original issue
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Address for correspondence:
04112, Ukraine, Kiev,
Dorogozhitskaya Str., 9,
P.L. Shupyk National Academy of Postgraduate Education of the MH of Ukraine,
the Pediatric Surgery Department,
e-mail:pedsurgery_ua@ukr.net,
tel. mobile +380 50 412-26-89,
Rybalchenko Vasyl F.
Information about the authors:
Rybalchenko Vasyl F., MD, Professor of the Pediatric Surgery Department, P.L.Shupyk National Academy of Postgraduate Education, Kiev, Ukraine.
https://orcid.org/0000-0002-1872-6948
Pereyaslov Andriy A., MD, Professor of the Pediatric Surgery Department,.Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
http://orcid.org/0000-0002-1225-0299
Rybalchenko Inna G., PhD, Pediatric Surgeon, Neonatal Surgery Department, National Children Specialized Hospital «OXMATDYT», Kiev, Ukraine.
https://orcid.org/0000-0003-0634-2725
Nykyforuk Olesya M., PhD, Assistant of the Pediatric Surgery Department, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0003-2967-5653
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