Spinelli P, Beretta G, Bajetta E, Tancini G, Castellani R, Rilke F, Bonadonna G
Br Med J. 1975 Dec 6;4(5996):554-6. doi: 10.1136/bmj.4.5996.554.
The relative merits of laparoscopy with liver and spleen biopsy and staging laparotomy were studied in 91 unselected patients with Hodgkin's disease. Laparoscopy with liver and spleen biopsy were combined with needle biopsy of the bone marrow and laparotomy was combined with open bone marrow biopsy. In 65 untreated patients six out of seven with liver or marrow disease, or both, were shown to have extranodal lymphomas in these sites by laparoscopy plus needle marrow biopsy. Among 26 patients who had been treated this finding occurred in six out of 10 patients. Spleen biopsies during laparoscopy detected infiltration by lymphoma in 14 out of 37 (38%) patients with diseases spleens. Morbidity was higher after laparotomy than after laparoscopy. Laparoscopy produced abdominal bleeding secondary to splenic biopsy in two patients. All patients with Hodgkin's disease should be subjected to laparoscopy plus needle marrow biopsy before undergoing laparotomy.
对91例未经挑选的霍奇金病患者研究了腹腔镜检查联合肝脾活检与分期剖腹术的相对优点。腹腔镜检查联合肝脾活检与骨髓穿刺活检相结合，剖腹术与开放性骨髓活检相结合。在65例未经治疗的患者中，通过腹腔镜检查加骨髓穿刺活检，7例有肝脏或骨髓疾病或两者皆有的患者中有6例在这些部位显示有结外淋巴瘤。在26例已接受治疗的患者中，10例患者中有6例出现了这一发现。腹腔镜检查期间的脾活检在37例有脾脏疾病的患者中有14例（38%）检测到淋巴瘤浸润。剖腹术后的发病率高于腹腔镜检查后。腹腔镜检查在2例患者中导致脾活检继发腹部出血。所有霍奇金病患者在接受剖腹术之前均应接受腹腔镜检查加骨髓穿刺活检。
