Cohen I T, Higgins G R, Powars D R, Hays D M
Arch Surg. 1977 Aug;112(8):948-51. doi: 10.1001/archsurg.1977.01370080046007.
The evaluation of a technique of laparotomy for the staging of Hodgkin's disease in childhood, including 52 operative procedures, is reviewed. A standard protocol, including splenectomy, multiple hepatic and bone marrow biopsies, and the routine sampling of at least six designated lymph node groups, was employed. It was demonstrated that the surgeon is unable to identify Hodgkin's disease by gross inspection and that the biopsy of node groups previously not included in routine laparotomy studies, ie, mesenteric and porta hepatis nodes is essential to staging in childhood. Stage was altered from stages I and II to stages III and IV in 35% of the patients. The incidence of abdominal recurrence following a negative laparotomy was 7%, and the incidence of post-splenectomy hyperacute infection was 4.5%. This study included minimal use of the lymphangiogram (33%), which accounted for the relatively larger group of patients in clinical stages I and II.
回顾了一项用于儿童霍奇金病分期的剖腹术技术评估，包括52例手术操作。采用了一个标准方案，包括脾切除术、多次肝脏和骨髓活检，以及对至少六个指定淋巴结组进行常规取样。结果表明，外科医生无法通过肉眼检查识别霍奇金病，对先前未纳入常规剖腹术研究的淋巴结组（即肠系膜和肝门淋巴结）进行活检对于儿童分期至关重要。35%的患者分期从I期和II期改变为III期和IV期。剖腹术结果为阴性后的腹部复发率为7%，脾切除术后超急性感染率为4.5%。本研究中淋巴管造影的使用较少（33%），这导致临床I期和II期的患者相对较多。
