Laparotomy in non Hodgkin's lymphomas
Laparotomía en linfomas no hodgkinianos
Resumen:
The authors present their experience and findings with staging laparotomy in 15 patients with nonHodgkin'slymphoma, during four years (1971-1975). The median age of the patients was 39,4 years. Seven were males and eight women. Diagnosis in all cases was confirmed by histopathology and classified m accordance with Rappaport. Lesions predominated in supradiafragmatic Iymph nades and high aero-digestive tract (13/15 cases). In this group, after laparotomy,38,4 % advanced in the clinicopathological classification, from stage I to stage III. Only in 6 cases bipodal lymphangiography could be done, but only in -one of these patients tumoral lymph nades could be seen at the leve! of the lymph nade axis; on the contrary 7 /15 laparotomi,ied patients ( 46,6 % ) presented tumoral lymph nades outside thelymph nade axis, so that they could not be seen radiologically. Morbimortality of laparotomy until 30 days was none. The importance of this technique far the clinicopathologicalstaging is enfathized, but insisting that far stage II non regional, stage III and IV it is not justified to employ it systematically. Instead, it is a most useful method in stage I and stage II regional, because it permits the finding of intraabdominal tumoral lymph nades that could not be proved by other paraclinical studies, implying this modifications in the previous clinico-pathological classification; since staging is more advanced a change to therapeutic schedules more appropiated to the real extension of the disease is necessary.
Los autores prese.ntan los hallazgos obtenidos con el empleo de la lapa.rotomía exploradora, con criterio de estadificación o de necesidad,en 15 pacientes portadores d.e linfomas no Hodgkinianos corr,espondientes al cuatrienio 1971-1975. La edad promedio fue de 39.4 años. Siete correspondieron al sexo masculino y ocho al femenino. En todos los casos se confirmó el diagnóstico hi-stológico y fueron dasificados de acuerdo a lo señalado por Rappaport. Fue franco el predominio lesional en regiones ganglionares supradiafragmáticas y en' vías aero-digestiva. s .superiores (13/15 casos). En este grupo de pacientes el 38,4 o/o luego de laparotomizados pasó a un estadio clínico-patológico más avanzado; es decir, del estadio I al III. Solamente en 6 casos se practicó una linfografía bipodal, que mostró adenopatías tumorales sobre el linfo-eje en un solo paciente,mientras que 7/15 laparotomizados, es decir, el 46,6 % de la casuística analizada presentaron adennopatías tumorales fuer a del linfo-eje, y por ende, no evidenciables radiológica.mente. La morbimortalidad de la laparotomía has.ta los 30 días de su real!ización fue nula en nuestra serie. Se efectúan consideraciones sobre la importanciaque tiene este procedimiento quirúrgico en la estadificación lesional, señalándose que para los estadios II no regionales, 111 y IV no se justifica su realización sistemática puesto queel tratamiento de elección es, en estos casos, poliquimioterápico. En cambio se la considera como un procedimiento útil, y muchas veces imprescindible, en los estadios iniciales I y II regionaies puesto que puede permitir la comprobación de adenopatías tumorales intra abdo del paciente .situánJdolo en un estadio más avanzado determinando así una conducta terapéutica diferente de la que surge de la estadificación clínica exclusiva.
1976 | |
linfomas terapia lymphomas therapy |
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Español | |
Sociedad de Cirugía del Uruguay | |
Revista Cirugía del Uruguay | |
https://revista.scu.org.uy/index.php/cir_urug/article/view/2769 | |
Acceso abierto |
Sumario: | The authors present their experience and findings with staging laparotomy in 15 patients with nonHodgkin'slymphoma, during four years (1971-1975). The median age of the patients was 39,4 years. Seven were males and eight women. Diagnosis in all cases was confirmed by histopathology and classified m accordance with Rappaport. Lesions predominated in supradiafragmatic Iymph nades and high aero-digestive tract (13/15 cases). In this group, after laparotomy,38,4 % advanced in the clinicopathological classification, from stage I to stage III. Only in 6 cases bipodal lymphangiography could be done, but only in -one of these patients tumoral lymph nades could be seen at the leve! of the lymph nade axis; on the contrary 7 /15 laparotomi,ied patients ( 46,6 % ) presented tumoral lymph nades outside thelymph nade axis, so that they could not be seen radiologically. Morbimortality of laparotomy until 30 days was none. The importance of this technique far the clinicopathologicalstaging is enfathized, but insisting that far stage II non regional, stage III and IV it is not justified to employ it systematically. Instead, it is a most useful method in stage I and stage II regional, because it permits the finding of intraabdominal tumoral lymph nades that could not be proved by other paraclinical studies, implying this modifications in the previous clinico-pathological classification; since staging is more advanced a change to therapeutic schedules more appropiated to the real extension of the disease is necessary. |
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