Baumberger U, Jungi W F, Fopp M, Schmid U, Senn H J
Schweiz Med Wochenschr. 1979 Sep 29;109(37):1386-8.
Whereas the contribution of exploratory laparotomy in Hodgkin's disease is well characterized, its value in Non-Hodgkin lymphoma (NHL) is not yet defined. This retrospective analysis of 31 cases is a contribution to the ongoing discussion. Laparotomy/splenectomy (LS) was done in 17 patients for diagnostic reasons and in 14 with therapeutic intent. Perioperative morbidity was low. In 17 cases the NHL had infiltrated the spleen. Indications for therapeutic LS were hemolytic anemia, pancytopenia and excessive lymphocytosis with granulocytopenia. The therapeutic benefit from splenectomy was satisfactory, especially in patients with well-differentiated lymphocytic leukemia of type CLL. In contrast, the diagnostic value of LS was minimal, except in patients with first diagnosis of NHL through LS. There was no change in tumor stage in any case. However, 4 false-negative findings contrast with the rapidly adverse course in these patients. Routine LS in patients with NHL does not appear to be justified, but has its value in NHL with primary abdominal localization. Therapeutic splenectomy is of benefit for the majority of patients, particularly those with CLL.
尽管剖腹探查术在霍奇金病中的作用已得到充分描述，但其在非霍奇金淋巴瘤（NHL）中的价值尚未明确。这项对31例病例的回顾性分析有助于正在进行的讨论。17例患者因诊断目的进行了剖腹术/脾切除术（LS），14例有治疗意图。围手术期发病率较低。17例中NHL已浸润脾脏。治疗性LS的指征为溶血性贫血、全血细胞减少以及伴有粒细胞减少的淋巴细胞增多症。脾切除术的治疗效果令人满意，尤其对于CLL型高分化淋巴细胞白血病患者。相比之下，LS的诊断价值极小，首次通过LS诊断NHL的患者除外。所有病例肿瘤分期均无变化。然而，4例假阴性结果与这些患者迅速恶化的病程形成对比。NHL患者常规进行LS似乎没有道理，但对于原发性腹部定位的NHL有其价值。治疗性脾切除术对大多数患者有益，尤其是CLL患者。
