Treatmet of infantile hemangiomas

Abstract

During last year in the Regional pediatric clinical hospital of Kharkov 53 children with volume, noninvoluting and complicated hemangiomas were treated. There were 39 children under1 year old, 10 children from 1 to 3 years old and 4 children over 3 years old. Before treatmet, patients were scheduled lab tests, USG of internal organs and brain, CT, MRI, and histological analysis of biopsy materials. Indications to different methods of treatment were determined by type, localization, size, intensity of growth and stage of tumor`s development. Surgery was performed on 19 children. Conservative treatment was assigned for 34 children. Systemic therapy with propranolol was conducted for 19 children. In 15 cases we used permanent compressive therapy with additional applications of timolol 0,5 % three times a day. Children under 1 year old with fast growing hemangiomas were administered with propranolol in therapeutic dose of 2 mg/kg a day. Complete cure was observed in 12 cases. In 7 cases stabilization of growth was achieved but there remained significant residual changes such as excessive tissues which required surgical interventions. Surgery was perfomed on 19 patients; for 3 of them cytoreductive surgery. During the interventions we used high-frequency electric coagulator in “overlap” regime. After cytoreductive surgery volume of tumor decreased and partial devasculation led to discontinuance of growth. Plastic material for further reconstructive surgery was preserved. Basic criteria for prescribing therapy which combined compression and local timolol 0,5% were moderate growth intensity, with localization on the extremities, head, chest where it is possible to perform effective compression. Within one month significant regression was observed. It was manifested as decrease of volume and area of tumor, paleness and absence of volume restoration after removal of compression. Usage of high-frequency electric coagulator, significantly improves conditions and results of surgical treatment. Combining local treatment of β-adrenoblockers and permanent compression is very effective in treatment of hemangiomas in children.