Clinical effect of surgical treatment of vascular anomalies in the sciatic nerve region
10.3760/cma.j.cn114453-20210120-00032
- VernacularTitle:手术治疗坐骨神经区域脉管性疾病的临床效果
- Author:
Li XIAO
1
;
Yanlin WANG
;
Qiuyu LIU
;
Dakan LIU
;
Changxian DONG
;
Song ZUO
Author Information
1. 河南省人民医院血管瘤科，郑州 450003
- Keywords:
Sciatic nerve;
Vascular anomalies;
Surgery;
Follow-up studies
- From:
Chinese Journal of Plastic Surgery
2022;38(3):265-274
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aims to discuss the clinical effect of surgical treatment of vascular anomalies in the sciatic nerve region.Methods:Retrospective analysis of clinical data was performed on patients with pain and dysfunction in the sciatic nerve region in the Department of Hemangioma, Henan Provincial People’s Hospital, between July 2013 and December 2018. The operation time, intraoperative blood loss, hospitalization time, postoperative complications, and wound healing were recorded. Postoperative follow-up included physical and imaging examination. Visual analogue scale (VAS) was used to evaluate the pain intensity before operation and at discharge. Oswestry dysfunction index (ODI) was used to evaluate the pain and limb function before operation and during follow-up.Results:This study enrolled 76 cases (32 males, aged from 2 to 55 years ), including 48 cases of venous malformation (VM), 9 cases of arteriovenous malformation (AVM), 6 cases of lymphatic malformation (LM), and 13 cases of fibro-adipose vascular anomaly (FAVA). Thirteen patients had been treated with local sclerotherapy, and four patients had been treated with interventional embolization for AVM without improvement or exacerbation. The operative time, intraoperative blood loss, and hospitalization time of FAVA patients were (113.33±30.11) min, (81.67±22.29) ml, and (3.83±0.98) d respectively, which were less than those of the other three vascular anomalies with the lest surgical damage and quickest recovery. The operative time, intraoperative blood loss, and hospitalization time of AVM patients were (288.33±33.71) min, (981.67±164.85) ml, and (11.17±1.47) d respectively, which were more than those of the other three vascular anomalies. The operation time of VM and LM cases was close, but the amount of blood loss [(396.67±85.71) ml] in VM cases varies greatly, with a minimum of 150 ml and a maximum of 1 100 ml. The vital signs of all patients were stable during and after the operation, without injury of main vessels and nerves. Seventy-one patients had grade A wound healing, four patients had grade B wound healing, and one patient had grade C wound healing. The postoperative follow-up was 6-36 months (mean 13 months), and the pain was completely relieved in 73 cases and partially relieved in 3 cases at the last follow-up. Seventy-two cases returned to normal, and 4 cases improved with lower limb dysfunction. Imaging examination showed that lesions of 70 cases disappeared and of 6 cases were residual. Preoperative VAS scores of four groups were 2.00 (1.00, 3.75), 2.00 (1.00, 3.50), 4.00 (0.75, 6.25), 4.00 (1.50, 6.00) respectively, and the postoperative VAS scores were all 0.00 (0.00, 0.00). The preoperative ODI scores of four groups were 17.78% (15.56%, 22.22%), 17.78% (13.33%, 35.56%), 50.00% (31.67%, 84.44%), 42.22% (31.11%, 56.67%). Apart from LM [4.44% (0.00%, 22.22%)], the postoperative ODI of the others was all 0.00% (0.00%, 0.00%). VAS and ODI were statistically significant differences before and after surgical treatment among all four groups ( P<0.05). Conclusions:Surgical treatment is safe and effective for vascular anomalies in the sciatic nerve region, which can significantly improve pain and joint mobility disorders.
