Laparotomy and Splenectomy in the Staging of Untreated Patients with Hodgkin's Disease

Diagnostic laparotomy and splenectomy were performed in 30 consecutive untreated patients with Hodgkin's disease. The preoperative assessment of splenic involvement was incorrect in 33%. There were no false-negative lymphangiograms; however, 6 of 13 positive studies could not be confirmed at surgery. Involvement of abdominal nodes outside the periaortic chain was found in 5 patients. The potential therapeutic benefit of routine laparotomy and splenectomy for staging is discussed.