Study on the Application of Indocyanine Green Lymphography in the Management of Microcystic Lymphatic Malformation: A Randomized Clinical Trial

Objective: To explore the application value of indocyanine green lymphography (ICGL) in the treatment of microcystic lymphatic malformation (mLM). Methods: This study was a prospective, randomized controlled clinical trial. Children with mLM who presented between November 2023 and November 2025 were recruited as subjects. They were randomly assigned in a 1:1 ratio to two groups: experimental group (ICGL-guided partial resection of mLM + penetration sclerotherapy), or control group (conventional partial resection of mLM + penetration sclerotherapy). Clinical baseline data were recorded, including gender, age, lesion location, and maximum lesion diameter. The primary outcomes were efficacy-related parameters (cure rate, effective rate, and number of subsequent treatments). Secondary outcome measures included intraoperative and postoperative parameters (operative time, postoperative drainage, follow-up duration) and related complications. Results: A total of 39 children completed the treatment and follow-up and were included in the final analysis (20 in experimental group and 19 in control group). The baseline characteristics were balanced and comparable between the two groups (p > 0.05). Regarding the primary outcomes, efficacy analysis revealed that the cure rate was significantly higher in the experimental group than in the control group (65.0% vs. 26.3%, p < 0.05). However, there were no significant differences between the groups in effective rate (experimental group: 95.0% vs. control group: 89.5%) or the number of cases requiring subsequent treatment (experimental group: 2 cases vs. control group: 3 cases) (p > 0.05). Furthermore, no statistical difference was observed between the two groups in secondary outcomes, including operative time, postoperative drainage, follow-up duration, or the incidence of postoperative complications (p > 0.05). Conclusions: ICGL-guided partial resection of mLM + penetration sclerotherapy improves postoperative outcomes in mLM. By enabling real-time intraoperative assessment of mLM lesion extent, this strategy facilitates resection of the main lesion and precise sclerotherapy of residual microcysts. These findings validate the significant application value of the ICGL in personalized treatment for mLM.