Glatstein E
Lymphology. 1977 Jun;10(2):126-31.
In the management of selected patient with malignant diseases, laparotomy can be useful for determining the anatomic extent of disease in order to individualize appropriate intensive treatment. The decision to subject a patient to a staging laparotomy requires joint decisions by surgeons, radiation therapists, chemotherapists, and diagnostic radiologists, after a thorough preoperative abdominal evaluation has been made. The lymphangiogram is especially important for directing the surgeon to a single node of concern. Special efforts must be made to insure that the specific node in question is biopsied. The justification of such a surgical procedure assumes that definitive decisions in management of such patients will result in an improved prognosis. While this appears to be the case with Hodgkin's disease and lymphomas, studies are underway to prove this assumption in other neoplasms. For most patients, staging laparotomy presently represents an investigational procedure of value only in selected patients. The critical problem is how these patients can be identified.
在选定的恶性疾病患者的管理中，剖腹术有助于确定疾病的解剖范围，以便制定个体化的适当强化治疗方案。在对患者进行术前腹部全面评估后，决定对患者进行分期剖腹术需要外科医生、放射治疗师、化疗师和诊断放射科医生共同做出决策。淋巴管造影对于引导外科医生关注单个可疑淋巴结尤为重要。必须特别努力确保对所讨论的特定淋巴结进行活检。这种外科手术的合理性在于，对这类患者的治疗做出明确决策将改善预后。虽然霍奇金病和淋巴瘤似乎是这种情况，但目前正在进行研究以在其他肿瘤中证实这一假设。对于大多数患者来说，分期剖腹术目前仅在选定的患者中是一种有价值的研究性手术。关键问题是如何识别这些患者。
