da Costa P M
Acta Chir Belg. 1975 Nov;74(6):602-15.
Between January 1, 1971 and February 1, 1974, 31 patients have undergone laparotomy for staging of a malignant lymphoma, Hobgkin or not. Laparotomy consisted in a median incision, above and below the umbilicus allowing multiple node biopsies, hepatic and splenic biopsies. In 17 cases out of 31, i.e. 54% preoperative clinical stage was changed by this explorative pathology. Among untreated cases, the most frequent change was from a low to a higher stage and inversely, among treated cases, most frequent changes were from plus towards minus. Postoperative mortality is nill and morbidity 5/31, i.e. 16%. This technique yields better definition of the degree of lymphoma extension, in particular intra-abdominal, and thus allows better treatment. The author thus commends explorative laparotomy with splenectomy for all malignant lymphomas, Hodgkin or not, except for stage IV, proven biopsy.
在1971年1月1日至1974年2月1日期间，31例患者接受了剖腹手术，以对恶性淋巴瘤进行分期，无论是否为霍奇金淋巴瘤。剖腹手术采用脐上下正中切口，以便进行多处淋巴结活检、肝脏和脾脏活检。31例中有17例，即54%，术前临床分期因这种探索性病理检查而改变。在未治疗的病例中，最常见的变化是从低分期变为高分期，相反，在已治疗的病例中，最常见的变化是从高分期变为低分期。术后死亡率为零，发病率为5/31，即16%。这项技术能更好地明确淋巴瘤的扩展程度，尤其是腹腔内的扩展程度，从而有助于更好地进行治疗。因此，作者推荐对所有恶性淋巴瘤，无论是否为霍奇金淋巴瘤，除了已证实活检为IV期的病例外，均进行带脾切除的探索性剖腹手术。
