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Critical Evaluation of Laparotomy and Splenectomy in Hodgkin's Disease

William R. Meeker Jr., MD; James D. Richardson, MD; Wilk O. West, MD; Joseph C. Parker, MD
Arch Surg. 1972;105(2):222-229. doi:10.1001/archsurg.1972.04180080076013.
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Thirty patients have had laparotomy for staging of Hodgkin's disease from 1967 to 1972 at Lexington, Ky, hospitals. Sixteen of 30 patients (53%) had alterations in staging as a result of laparotomy. Fourteen patients were reclassified to a more advanced stage and two patients to a less advanced stage. Clinical assessment of abdominal involvement was in error in 54% of 26 evaluative patients. The most frequent histologic type in these patients was mixed cellularity noted in 46% of all slides examined. Thirteen of 30 patients (43%) had combined histologic types noted at different anatomic sites at the same time. The value of laparotomy and splenectomy in staging of Hodgkin's disease is confirmed. Significant morbidity and mortality occurred (27% and 6.6% respectively). We recommend that selective criteria be defined for laparotomy and splenectomy in staging patients with Hodgkin's disease.


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