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Staging Laparotomy for Hodgkin's Disease in ChildrenEvaluation of the Technique
Ian T. Cohen, MD;
Gussie R. Higgins, MD;
Darleen R. Powars, MD;
Daniel M. Hays, MD
Arch Surg. 1977;112(8):948-951.
Abstract
• 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.
(Arch Surg 112:948-951, 1977)
Author Affiliations
From the Division of Pediatric Surgery, Department of Surgery, University of Southern California School of Medicine, Los Angeles.
Footnotes
Accepted for publication April 11, 1977.
Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Palm Springs, Calif, Jan 14, 1977.
Reprint requests to Childrens Hospital of Los Angeles, PO Box 54700, Terminal Annex, Los Angeles, CA 90054 (Dr Cohen).
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