Radical excision of lumbosacral lipoma

an early experience of “followers”

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Indication, timing, and method for surgical treatment of lumbosacral lipoma are controversial. Radical resection of the lumbosacral lipoma and complete reconstruction of the placode are supported in that better long-term outcome can be achieved without increasing complication rate compared with traditional surgical techniques. Objective: We analyzed the early surgical outcomes of lumbosacral lipoma treated with the untethering and radical excision of fat. Methods: Retrospective analysis of surgically treated 81 fresh lumbosacral lipoma cases with dorsal, transitional, and chaotic types and true lipomyelomeningocele (LMMC) was performed. Caudal and filar types were excluded. Results: Complete untethering was accomplished in 98%. Radical excision of the lipoma was attempted in all cases and achieved in 83%. Postoperative neurological complication was observed in 8 cases (10%). Group of lipoma types (dorsal + transitional vs. chaotic + true LMMC) and availability of radical lipoma excision turn out to be factors related to neurological outcomes in univariate analysis (p < 0.001 and p = 0.027, respectively). Group of lipoma types, availability of radical excision, and postoperative cord/dural sac (C/D) ratio are related factors in multivariate analysis (p = 0.025, p = 0.049, and p = 0.031). Conclusions: As a follower of untethering and radical excision of fat, careful consideration is required to plan the surgery of lumbosacral lipoma on account of the “underestimated” complication rate. Type of the lipoma is the important factor determining the surgical outcome. Availability of complete radical excision and postoperative C/D ratio are the operative factors related to the neurological outcomes.

Original languageEnglish
Pages (from-to)1591-1597
Number of pages7
JournalChild's Nervous System
Volume35
Issue number9
DOIs
StatePublished - 1 Sep 2019

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Lipoma
Fats
Multivariate Analysis

Keywords

  • Complications
  • Lumbosacral lipoma
  • Neurological outcome
  • Radical excision
  • Untethering

Cite this

@article{531a153ff3c947c1b518ec9150cccb9e,
title = "Radical excision of lumbosacral lipoma: an early experience of “followers”",
abstract = "Background: Indication, timing, and method for surgical treatment of lumbosacral lipoma are controversial. Radical resection of the lumbosacral lipoma and complete reconstruction of the placode are supported in that better long-term outcome can be achieved without increasing complication rate compared with traditional surgical techniques. Objective: We analyzed the early surgical outcomes of lumbosacral lipoma treated with the untethering and radical excision of fat. Methods: Retrospective analysis of surgically treated 81 fresh lumbosacral lipoma cases with dorsal, transitional, and chaotic types and true lipomyelomeningocele (LMMC) was performed. Caudal and filar types were excluded. Results: Complete untethering was accomplished in 98{\%}. Radical excision of the lipoma was attempted in all cases and achieved in 83{\%}. Postoperative neurological complication was observed in 8 cases (10{\%}). Group of lipoma types (dorsal + transitional vs. chaotic + true LMMC) and availability of radical lipoma excision turn out to be factors related to neurological outcomes in univariate analysis (p < 0.001 and p = 0.027, respectively). Group of lipoma types, availability of radical excision, and postoperative cord/dural sac (C/D) ratio are related factors in multivariate analysis (p = 0.025, p = 0.049, and p = 0.031). Conclusions: As a follower of untethering and radical excision of fat, careful consideration is required to plan the surgery of lumbosacral lipoma on account of the “underestimated” complication rate. Type of the lipoma is the important factor determining the surgical outcome. Availability of complete radical excision and postoperative C/D ratio are the operative factors related to the neurological outcomes.",
keywords = "Complications, Lumbosacral lipoma, Neurological outcome, Radical excision, Untethering",
author = "Sangjoon Chong and Lee, {Ji Yeoun} and Kim, {Kyung Hyun} and Hyung-Ik Shin and Kim, {Kee Won} and Kwanjin Park and Seung-Ki Kim and Kyu-Chang Wang",
year = "2019",
month = "9",
day = "1",
doi = "10.1007/s00381-019-04212-1",
language = "English",
volume = "35",
pages = "1591--1597",
journal = "Child's Nervous System",
issn = "0256-7040",
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Radical excision of lumbosacral lipoma : an early experience of “followers”. / Chong, Sangjoon; Lee, Ji Yeoun; Kim, Kyung Hyun; Shin, Hyung-Ik; Kim, Kee Won; Park, Kwanjin; Kim, Seung-Ki; Wang, Kyu-Chang.

In: Child's Nervous System, Vol. 35, No. 9, 01.09.2019, p. 1591-1597.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Radical excision of lumbosacral lipoma

T2 - an early experience of “followers”

AU - Chong, Sangjoon

AU - Lee, Ji Yeoun

AU - Kim, Kyung Hyun

AU - Shin, Hyung-Ik

AU - Kim, Kee Won

AU - Park, Kwanjin

AU - Kim, Seung-Ki

AU - Wang, Kyu-Chang

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Background: Indication, timing, and method for surgical treatment of lumbosacral lipoma are controversial. Radical resection of the lumbosacral lipoma and complete reconstruction of the placode are supported in that better long-term outcome can be achieved without increasing complication rate compared with traditional surgical techniques. Objective: We analyzed the early surgical outcomes of lumbosacral lipoma treated with the untethering and radical excision of fat. Methods: Retrospective analysis of surgically treated 81 fresh lumbosacral lipoma cases with dorsal, transitional, and chaotic types and true lipomyelomeningocele (LMMC) was performed. Caudal and filar types were excluded. Results: Complete untethering was accomplished in 98%. Radical excision of the lipoma was attempted in all cases and achieved in 83%. Postoperative neurological complication was observed in 8 cases (10%). Group of lipoma types (dorsal + transitional vs. chaotic + true LMMC) and availability of radical lipoma excision turn out to be factors related to neurological outcomes in univariate analysis (p < 0.001 and p = 0.027, respectively). Group of lipoma types, availability of radical excision, and postoperative cord/dural sac (C/D) ratio are related factors in multivariate analysis (p = 0.025, p = 0.049, and p = 0.031). Conclusions: As a follower of untethering and radical excision of fat, careful consideration is required to plan the surgery of lumbosacral lipoma on account of the “underestimated” complication rate. Type of the lipoma is the important factor determining the surgical outcome. Availability of complete radical excision and postoperative C/D ratio are the operative factors related to the neurological outcomes.

AB - Background: Indication, timing, and method for surgical treatment of lumbosacral lipoma are controversial. Radical resection of the lumbosacral lipoma and complete reconstruction of the placode are supported in that better long-term outcome can be achieved without increasing complication rate compared with traditional surgical techniques. Objective: We analyzed the early surgical outcomes of lumbosacral lipoma treated with the untethering and radical excision of fat. Methods: Retrospective analysis of surgically treated 81 fresh lumbosacral lipoma cases with dorsal, transitional, and chaotic types and true lipomyelomeningocele (LMMC) was performed. Caudal and filar types were excluded. Results: Complete untethering was accomplished in 98%. Radical excision of the lipoma was attempted in all cases and achieved in 83%. Postoperative neurological complication was observed in 8 cases (10%). Group of lipoma types (dorsal + transitional vs. chaotic + true LMMC) and availability of radical lipoma excision turn out to be factors related to neurological outcomes in univariate analysis (p < 0.001 and p = 0.027, respectively). Group of lipoma types, availability of radical excision, and postoperative cord/dural sac (C/D) ratio are related factors in multivariate analysis (p = 0.025, p = 0.049, and p = 0.031). Conclusions: As a follower of untethering and radical excision of fat, careful consideration is required to plan the surgery of lumbosacral lipoma on account of the “underestimated” complication rate. Type of the lipoma is the important factor determining the surgical outcome. Availability of complete radical excision and postoperative C/D ratio are the operative factors related to the neurological outcomes.

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