Abbasoğlu L, Gün F, Salman F T, Celik A, Unüvar A, Görgün O
Department of Pediatric Surgery, Istanbul University, Istanbul Medical School, Istanbul, Turkey.
Eur J Pediatr Surg. 2003 Aug;13(4):236-9. doi: 10.1055/s-2003-42242.
The role of surgery in intraabdominal Burkitt's lymphoma remains controversial and different opinions are present in the literature. In our institution, forty patients (30 boys and 10 girls) with intraabdominal Burkitt's lymphoma with ages ranging from 3 to 12 years have been treated and followed from 1989 through 2000. In ten cases, the patients underwent surgery because of their acute abdominal diseases (intestinal obstruction in 5, intussusception in 3, intestinal perforation in one, and acute appendicitis in one). The remaining thirty patients were referred to our clinic because of their abdominal masses, pain, anorexia and fatigue. Twelve children had localized tumors and total resection could be performed. There was one death in this group due to central nervous system involvement during chemotherapy. In the remaining 28 children, extensive intraabdominal diseases were detected. In four of them, debulking procedures were performed, while in 24 children only biopsies could be made; 8 of them underwent a second-look operation. In the debulking procedures group, two children were lost (50 %) due to tumorlysis and acute renal failure. In the biopsy group, there were six deaths (25 %). All patients received chemotherapy after operative recovery. In conclusion, our results suggest that when the tumor is localized, total resection results in a good outcome. However, in the presence of extensive intraabdominal diseases instead of resection, the operation should be limited to biopsy only.
手术在腹腔内伯基特淋巴瘤中的作用仍存在争议，文献中也存在不同观点。在我们机构，自1989年至2000年共治疗并随访了40例腹腔内伯基特淋巴瘤患者（30例男孩和10例女孩），年龄在3至12岁之间。其中10例患者因急性腹部疾病接受手术（5例肠梗阻、3例肠套叠、1例肠穿孔、1例急性阑尾炎）。其余30例患者因腹部肿块、疼痛、厌食和乏力前来就诊。12例儿童为局限性肿瘤，可行根治性切除。该组中有1例患者在化疗期间因中枢神经系统受累死亡。其余28例儿童存在广泛的腹腔内病变。其中4例进行了肿瘤减积手术，24例仅进行了活检；8例接受了二次探查手术。在肿瘤减积手术组中，2例儿童因肿瘤溶解和急性肾衰竭死亡（50%）。活检组中有6例死亡（25%）。所有患者术后恢复后均接受了化疗。总之，我们的结果表明，当肿瘤局限时，根治性切除可取得良好预后。然而，当存在广泛的腹腔内病变时，不应进行切除手术，而应仅限于活检。
