Sterchi J M, Myers R T
Ann Surg. 1980 May;191(5):570-5. doi: 10.1097/00000658-198005000-00008.
Staging laparotomy (multiple liver and lymph node biopsies and splenectomy) was performed at the North Carolina Baptist Hospital in 123 patients with Hodgkin's disease. There were no deaths. Wound, pulmonary, intra-abdominal or urinary tract complications developed in 17 patients. Of those complications, one case each of pelvic abscess, subphrenic abscess, small bowel obstruction, staphylococcal peritonitis and subphrenic hematoma required a major intra-abdominal operation. The patients were classified on the basis of histopathology; nodular sclerosis--40, mixed cellularity--44, lymphocyte predominant--24, lymphocyte depleted--13, and undetermined--2. The pathological stage following laparotomy was unchanged from the clinical stage in 62%, reduced in 15%, and advanced in 23%. Subsequent therapy, therefore, was altered in 38% of the patients. Lymphangiography, done in 108 patients, showed lymph node involvement in 46 patients and no involvement in 62 patients. Of those lymphangiographic findings, 79% were confirmed histopathologically, 19% were falsely positive, and 1.8% were falsely negative. There were positive findings of Hodgkin's disease in the spleen in 42% of patients. The staging laparotomy continues to be a valuable tool in the staging and treatment of Hodgkin's disease.
123例霍奇金病患者在北卡罗来纳州浸信会医院接受了分期剖腹手术（多次肝脏及淋巴结活检和脾切除术）。无死亡病例。17例患者出现伤口、肺部、腹腔内或泌尿道并发症。在这些并发症中，盆腔脓肿、膈下脓肿、小肠梗阻、葡萄球菌性腹膜炎和膈下血肿各1例需要进行大型腹腔内手术。患者根据组织病理学进行分类：结节硬化型40例，混合细胞型44例，淋巴细胞为主型24例，淋巴细胞消减型13例，未定型2例。剖腹手术后的病理分期与临床分期相比，62%未变，15%降低，23%升高。因此，38%的患者后续治疗方案发生了改变。108例患者进行了淋巴管造影，46例显示有淋巴结受累，62例未受累。在这些淋巴管造影结果中，79%经组织病理学证实，19%为假阳性，1.8%为假阴性。42%的患者脾脏有霍奇金病阳性发现。分期剖腹手术仍然是霍奇金病分期和治疗的一项重要手段。
