LAPAROSCOPIC EVALUATION OF LYMPHOMA

Surgeons are involved in the diagnosis and staging of patients with ly mphoma. Treatment requires accurate information about histologic class ification and the extent of disease. While most patients with non-Hodg kin's lymphoma are treated with systemic chemotherapy, the exact stage of disease in patients with Hodgkin's lymphoma may determine the ther apy to be used. The use of minimally invasive surgery in surgical stag ing of patients with Hodgkin's disease has the potential to decrease t he morbidity and mortality of the staging procedure in these patients. All of the components of a staging procedure (liver biopsies, splenec tomy, lymph node biopsies, and oophoropexy) can be performed laparosco pically. The procedure is performed with the patient in the supine pos ition. After obtaining several liver biopsies, the splenectomy is comp leted. Lymph nodes are then sampled from the celiac, portal, iliac, an d peri-aortic regions. Lymph nodes identified as abnormal on pre-opera tive imaging studies are identified and excised. While each of these p rocedures is technically challenging, the laparoscopic conduct of this diagnostic procedure may afford patients decreased post-operative mor bidity and mortality. (C) 1998 Wiley-Liss, Inc.