What are the roles of surgery in vascular anomalies?Management of vascular anomalies often involve multi-disciplinary collaboration.
Surgery may be required for diagnosis (i.e. tissue biopsies), treatment (resection of vascular anomalies, with or without reconstruction) or treatment of complications caused by the lesion (eg tracheostomy, to bypass airway obstruction).
Surgery, sometimes followed by reconstruction, may be used in conjunction with other treatments. If there are widespread, deep lesions, multiple treatments are often necessary.
Surgery is performed by the relevant paediatric surgical specialist (general surgeon, orthopaedic surgeon, ENT surgeon, neurosurgeon etc), and plastic surgeon if reconstruction is required.
What is a biopsy and how is it performed? A biopsy is performed to obtain a small sample of the lesion for histologic examination under a microscope to determine the type of vascular anomaly.
It is usually performed with a special needle, or by making a small cut over the lesion and removing a small piece of tissue sample. It is a minor surgery and usually can be performed as a day surgery procedure.
When is surgical resection of a vascular anomaly needed? Surgical resection of the vascular anomaly may be the only treatment required especially for small localised lesions.
For more extensive and widespread lesions, surgical resection, sometimes followed by reconstruction, may be performed as part of the multimodality treatment in conjunction with other treatments including sclerotherapy and medical therapy.
How is surgical resection performed? Surgical resection of vascular lesions requires careful pre-operative planning.
The aim of surgery is to achieve adequate resection to prevent recurrence, without causing disfigurement, or affecting the function of the surrounding organs. At times, multiple surgeries may be required.
Sometimes, surgical resection will be followed by reconstruction by the plastic surgeon at the same or delayed setting.
What are the risks of surgical resection? The immediate risks during surgery include risk of general anaesthesia, bleeding and injury to the surrounding structures.
Potential post-operative problems include pain, wound infection, disfigurement and recurrence. Rarely, lesions may recur after surgical removal, either in the original site, or in other areas where new vascular anomalies may develop in future.
The information above is also available for download in pdf format.
