Evaluating Outcomes Following Sclerotherapy and Surgery for Pediatric Lymphatic Malformations Using a Large Multicentric Database

Monday, October 19, 2026

8:06 AM - 8:12 AM PT

Location: 409AB

Presenting Author(s)

MT

Mishek Thapa, BS

Medical Student
David Geffen School of Medicine, University of California, Los Angeles
Los Angeles, California, United States

Co-Author(s)

Albert Y. Li, BA

Medical Student
Keck School of Medicine
Los Angeles, CA, United States
NV

Nathan Vu, BS

Medical Student
David Geffen School of Medicine, UCLA, United States
Matthew E. Lin, MD

Resident Physician
UCLA Department of Head and Neck Surgery
Los Angeles, CA, United States
IK

Ian Kim, PhD

Senior Research Scientist
Department of Pediatrics, Stanford Medicine, Stanford, California, USA; Stanford Prevention Research Center, Stanford Medicine, Stanford, California, USA., United States

Senior Author(s)

SK

Sohit P. Kanotra, MD, MBA, FACS

Professor of Head and Neck Surgery , Director Complex Pediatric Airway Disorders
UCLA School of Medicine
Los Angeles, California, United States

Disclosure(s):

Mishek Thapa, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Matthew E. Lin, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Lymphatic malformations (LM) are congenital vascular anomalies often localized to the head and neck, managed through sclerotherapy or surgical excision, yet comparative long-term outcomes remain poorly characterized. This study evaluates 5-year recurrence, complications, and retreatment rates in a propensity-matched pediatric cohort.

Methods: Retrospective study of patients < 18 years undergoing sclerotherapy (n=645; doxycycline 386, bleomycin 124, STS 108) versus surgery (n=1007) for LMs. Propensity score matching based on demographics, comorbidities, and healthcare utilization yielded balanced cohorts (n=576 per group) with standardized differences < 0.20. Five-year outcomes were analyzed using Cox proportional hazards models.

Results: Cohorts were well-balanced (mean age 6.35 vs 6.14 years, 50% female). Over 5 years, both modalities demonstrated comparable efficacy. Recurrence rates after 2 years were similar (11.83% vs 10.57%, HR 1.05, p=0.604). No significant differences emerged in hospitalization (HR 0.90, p=0.504), feeding difficulty (HR 0.81, p=0.580), pneumonia (HR 0.53, p=0.074), or cellulitis (HR 0.68, p=0.2). Sclerotherapy showed modestly increased head and neck skin swelling (7.52% vs 3.89%, HR 2.04, p=0.014). Sclerotherapy patients required more retreatment (68.87% vs 58.27%, HR 1.59, p=0.001) but fewer total treatments (2.024 vs 2.4, p=0.03).

Conclusions: Sclerotherapy and surgery achieve comparable long-term LM control with similar recurrence and complications. While sclerotherapy requires more retreatment, both are effective. Treatment selection should consider disease complexity, anatomic location, and family preferences.