Surgical Management of Pediatric Lymphatic Malformations: A Cross-Sectional Study of Outcomes, Complications, and Recurrence at a Tertiary Care Center.

Background and Aims: Lymphatic malformations (LMs) are congenital anomalies of the lymphatic system, frequently affecting pediatric populations. While complete surgical excision remains a primary therapeutic option, factors influencing outcomes, including lesion location and age at intervention, remain inadequately explored. This study investigates surgical outcomes, complications, and recurrence rates associated with LMs in children at a tertiary care center over a 6-year period. Methods: A retrospective, cross-sectional study was conducted at Children University Hospital (Damascus University) from April 2017 to May 2023. Forty children aged 0-12 years underwent surgical intervention for LMs. Data were collected on demographics, lesion location, age at intervention, surgical approaches, and postoperative outcomes. Associations between surgical comprehensiveness, age, lesion site, and complications were analyzed using descriptive statistics. Results: Head and neck were the most common lesion sites (55%), with 25% of cases operated on after 5 years of age. Complete excision was achieved in 82.5% of cases, with no recurrence in this group. Complications, including temporary nerve paresis and seromas, occurred in 25% of cases, predominantly in older children. Early intervention (6-12 months) yielded a 100% success rate with no complications or recurrences, suggesting this as an optimal window for surgery. Conclusions: Early surgical intervention for LMs, particularly within the first year of life, may offer favorable outcomes with minimal complications in carefully selected cases. While complete excision remains a goal when feasible, individualized management-including sclerotherapy or systemic therapy-should be considered based on lesion characteristics and multidisciplinary evaluation.