Dent D M, King H S, Jacobs P
S Afr Med J. 1982 Oct 2;62(15):509-11.
A series of 100 patients with Hodgkin's disease were submitted to staging laparotomy, without mortality and with negligible morbidity. Thirty-one patients were restaged: 23 had occult intra-abdominal disease and 8 false-positive lymphangiograms. Standardized treatment programmes were tested against our clinical and pathological data to determine whether staging laparotomy would alter therapeutic decisions. Programmes based on clinical staging and employing radical radiotherapy would have encompassed all disease without recourse to laparotomy. In contrast, a more conservative programme which employed mantle field irradiation for clinically localized cervical disease, without laparotomy, would have missed disease in 12% of cases. Patients with supradiaphragmatic nodal Hodgkin's disease should either have prophylactic abdominal irradiation (without laparotomy) or more limited radiotherapy determined by laparotomy (without prophylactic irradiation).
100例霍奇金病患者接受了分期剖腹探查术，无死亡病例，发病率可忽略不计。31例患者重新分期：23例有隐匿性腹腔内疾病，8例淋巴管造影呈假阳性。根据我们的临床和病理数据对标准化治疗方案进行了测试，以确定分期剖腹探查术是否会改变治疗决策。基于临床分期并采用根治性放疗的方案本可涵盖所有疾病，而无需进行剖腹探查术。相比之下，一个更保守的方案是，对于临床局限于颈部的疾病，不进行剖腹探查术，仅采用斗篷野照射，会有12%的病例漏诊疾病。膈上淋巴结霍奇金病患者应要么接受预防性腹部照射（不进行剖腹探查术），要么通过剖腹探查术确定更有限的放疗方案（不进行预防性照射）。
