Anatomical-clinical correlation of the patients examined

Correlación anatomo-clínica de los enfermos explorados

Cat, Juan M - Sica, Miguel A - Mata, Hermes - Kasdorf, Helmut

Resumen:

In the course of current research on Hodgkin's dísease, the authors indicated exploratory laparotomy with splenectomy and liver and ganglionic biopsis, i'n32 patients, 21 of wham had never been treated and 11 presented evolution. In the first group they found modification of the stage established by clinical andparaclinical procedure.s in 13 cases, the majority in a more advanced state than expected, but also (2) in a less advanced stage of the disease. In the secondgroup, active foci were found, which had not appeared when ordinary procedures had been employed. Results obtained in each of the abdominal sectorsstudied ( spleen, ganglia and live.r) are analyzed in this paper and compared with those resulting from élassic procedures. It should be noted that: 1) themajority of splenic lesions could not have been suspected with clinical methods; 2) there was high incidence of Hodgkin-type adenopathies in locations outside thelymphographic area which it would have been impossible to detect by classic methods; 3) this study confirms that Jiver involvement is rare when ther-e is no splenic localization.In view of the importance .of arriving at a correct definition of the stage of the disease for the purpose of deciding upons the therapy to be applied -as well as the fact that splenectomy is the most efficien( type of treatment far this localization- the auhors favour sysematic application of laparotomy and splenectomy far the three first stages of Hodgkin's disease.


Los autores, siguiendo investigaciones en curso, indicaron una laparotomía exploradora con esplenectomía, biopsia hepática y ganglionar en 32 casos de enfermedadde Hodgkin, 21 de los cuales eran vírgenes de tratamiento y  11 evolucionados. En el primer grupo encuentran modificación en, el estadía establecido por la clínica y paraclínica en 13 casos, la mayoría hacia estadías más avanzados  pero también hacia menos avanzados . En el segundo grupo puso de manifiesto focos activos que no habían podido demostrarsepor los procedimientos habituales. Se analizan los resultados obtenidos en cada uno de los sectores abdominales investigados (bazo, gangliose hígado) y se comparan con los derivados de los métodos clásicos. Se destaca que: 1) La mayoría de las lesiones espÍénicas no podían sospecharse porlos métodos clínicos ( 11 de 23 casos sin esplenomegalia); 2) La elevada frecuencia de adenopatías hodgkinianas en sectores ubicados fuera del área linfográfica poda! e imposibles de detectar por otros métodos; 3) Se confirma que la participación hepática es excepcional cuando no hay localización esplénica. Teniendo en cuenta la _importancia de la correctaestadificación en e.J planteo terapéutico de esta enfermedad y el hecho de que la esplemectomía constituye la forma de tratamiento más eficaz de esta localización,los autores se de.muestran partidarios de la realización sistemática de la laparotomía y esplenectomía en los 3 primeros estadías de la enfermedad de Hodgkin.


Detalles Bibliográficos
1972
enfermedad de Hodgkin
tratamiento
Hodgkin disease
treatment
Español
Sociedad de Cirugía del Uruguay
Revista Cirugía del Uruguay
https://revista.scu.org.uy/index.php/cir_urug/article/view/2278
Acceso abierto
Resumen:
Sumario:In the course of current research on Hodgkin's dísease, the authors indicated exploratory laparotomy with splenectomy and liver and ganglionic biopsis, i'n32 patients, 21 of wham had never been treated and 11 presented evolution. In the first group they found modification of the stage established by clinical andparaclinical procedure.s in 13 cases, the majority in a more advanced state than expected, but also (2) in a less advanced stage of the disease. In the secondgroup, active foci were found, which had not appeared when ordinary procedures had been employed. Results obtained in each of the abdominal sectorsstudied ( spleen, ganglia and live.r) are analyzed in this paper and compared with those resulting from élassic procedures. It should be noted that: 1) themajority of splenic lesions could not have been suspected with clinical methods; 2) there was high incidence of Hodgkin-type adenopathies in locations outside thelymphographic area which it would have been impossible to detect by classic methods; 3) this study confirms that Jiver involvement is rare when ther-e is no splenic localization.In view of the importance .of arriving at a correct definition of the stage of the disease for the purpose of deciding upons the therapy to be applied -as well as the fact that splenectomy is the most efficien( type of treatment far this localization- the auhors favour sysematic application of laparotomy and splenectomy far the three first stages of Hodgkin's disease.