Staging laparotomy for Hodgkin's disease.

Splenectomy was performed in patients with Hodgkin's disease in a prospective study at the University Hospital of Umeå 1973-1978. Fifty-nine subjects were included and the laparotomy was made as a part of the pre-treatment investigation. The result of the surgical exploration was compared to other investigations, e.g., lymphangiography or cavography. The operation morbidity was 5% (3/59). The clinical stage was changed in 15/58 (26%). Fourteen upstaged and one downstaged. The macroscopical evaluation was poorly correlated to the histological involvement. It is concluded that if the staging procedure is performed by specialized surgeons the morbidity is low. No adverse effects have yet been observed after splenectomy. The staging laparotomy and splenectomy is considered superior to nonsurgical staging procedures from both treatment and cost benefit point of view.