Short-term Postoperative Complications of Lymphatic Malformation Surgical Excision: A 20-Year Institutional Review

Objective: To evaluate outcomes and postoperative complications following surgical resection of lymphatic malformations (LMs) at a single multidisciplinary vascular anomalies center.

Methods: A single-center retrospective review of all patients ≤21 years old who underwent surgical resection of a lymphatic malformation at a quaternary referral center with a multidisciplinary vascular anomalies team from 2004 to 2024. Data pertaining to postoperative outcomes and treatments was abstracted.

Results: A total of 109 surgical procedures were included and examined. The most common 30-day postoperative complications included: seroma (18.3 %), superficial surgical site infection (18.3 %), and wound dehiscence (12.8 %), with lower rates of nerve palsy/injury (5.5 %), lymphedema (2.8 %), hematomas (3.7 %), and abscesses (4.6 %). An interventional radiology procedure within 30-days postoperatively was required for management of seroma in 8 patients (7.3 %), while 7 (6.4 %) patients required reoperation. Among patients who underwent attempted complete resection, recurrence of the LM was documented in 32.0 % (16/50). Subjective quality of life improvement was noted in 69.7 %. There was no difference in incidence of postoperative complications reported in patients who underwent preoperative sclerotherapy vs those that did not (p = 0.980).

Conclusion: Seroma and surgical site infection were the most reported short-term postoperative complications followed by wound dehiscence with low rates of other complications in surgical resection of LMs. Few patients required postoperative procedural intervention. Despite a relatively high rate of short-term complications, patients reported high satisfaction and symptom improvement following LM resection, which underscores the important role for surgical management of LMs in select patients.

Level of evidence: III.

Type of study: Cohort study.