Vascular tumors and malformations of the pelvic and genital region – Classification and laser treatment

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• 作者：Carsten M. Philipp ; Margitta Poetke ; Hans-Peter Berlien
• 关键词：Laser ; FPDL ; KTP ; Pulsed Nd ; YAG laser ; Nd ; YAG laser ; Diode laser ; Hemangioma ; Vascular malformation ; Angiodysplasia ; Selective photothermolysis ; Interstitial ; Intraluminal
• 刊名：Medical Laser Application
• 出版年：2009
• 出版时间：February 2009
• 年：2009
• 卷：24
• 期：1
• 页码：27-51
• 全文大小：5407 K

文摘

Hemangiomas in infancy and vascular malformations (VM) such as port-wine stains, venous, arteriovenous, lymphatic or mixed malformations of the anogenital region may present considerable problem for patients at different stages of their individual development. A clear differentiation between the different entities is important for the choice of the proper therapy (from none to immediate intervention). Whereas hemangiomas are vascular tumors which arise during the first weeks of the newborn period, VM may be present at birth or be recognized later, but usually show little or no progress in infancy. Their growth tendency is related to the vessel types involved but is mainly influenced by the anatomical and functional situation of the malformed and “normal” regional vessels involved. Both types of vascular anomalies may present an “iceberg phenomenon” where the clinically visible portion is only a small part of the whole picture.

As hemangiomas show a spontaneous regression, the treatment is aimed at preventing complications such as ulcerations and excessive growth which could lead to secondary problems, e.g. in urine flow or defecation and infection. Treatment will usually be completed during the first year of life, employing laser treatment, corticoid medication and sometimes surgery.

The treatment of VM is symptomatic. Complete healing is usually not possible with non-mutilating strategies; long-term recurrences are frequent. Swelling, bleeding and obstruction may occur during adolescence or later (e.g. during pregnancy) and usually mark the onset of therapy. An individualized and effective therapy requires a complete understanding of the anatomy of the malformation and employs various techniques such as laser sclerotherapy and surgery, with either a direct or endoscopical approach.