SURGICAL EXPLORATION OF THE ABDOMINAL LYMPHATIC SYSTEM IN PATIENTS WITH MALIGNANCIES

E Glatstein

Abstract


In the management of selected patient with malignant
diseases, laparotomy can be useful for determining
the anatomic exstent of disease in order to individualize
appropriate intensive treatment. The decision
to subject a patient to a staging; laparotomy
requires joint decisions by surgeons, radiation
therapists, chemotherapists, and diagnostic radiologists,
after a thorough preoperative abdominal evaluation
has been made. The lymphangiogram is especially
important for directing the surgeon to a
single node of concern. Special efforts must be made
to insure that the specific node in question is
biopsied.
The justification of such a surgical procedure assumes
that definitive decisions in management of such
patients will result in an improved prognosis. While
this appears to be the case with Hodgkin's disease
and lymphomas, studies are underway to prove this
assumption in other neoplasms. For PtOSt patients,
staging laparotomy presently represepts an investigational
procedure of value only in selected patients.
The critical problem is how these patients can be
identified.


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