Risk of Severe Infection in Patients with Hodgkin's Disease or Lymphoma After Diagnostic Laparotomy and Splenectomy

Editorials1 July 1972Risk of Severe Infection in Patients with Hodgkin's Disease or Lymphoma After Diagnostic Laparotomy and SplenectomyRICHARD K. DESSER, M.D., JOHN E. ULTMANN, M.D., F.A.C.P.RICHARD K. DESSER, M.D.Search for more papers by this author, JOHN E. ULTMANN, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-77-1-143 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn many treatment centers in the United States and abroad, case evaluation in Hodgkin's disease or lymphoma has come to include diagnostic laparotomy and splenectomy. Introduction of this method has generated a lively controversy, some of which has appeared in previous issues of this journal (1-3). Further controversy is certain to be raised by the reports in this issue by Ravry and associates and Nixon and Aisenberg, who suggest that splenectomy as part of the diagnostic laparotomy may pose a special long-term risk for severe infections*. Consequently, assessment of this risk, relative to the advantages of diagnostic splenectomy in Hodgkin's...References1. JOHNSON R: Is staging laparotomy routinely indicated in Hodgkin's disease? Ann Intern Med 75:459-462, 1971 LinkGoogle Scholar2. LOKICHJOHNSON JR: Staging laparotomy (letter). Ann Intern Med 76:143-144, 1972 LinkGoogle Scholar3. ULTMANNJOHNSON JR: Hodgkin's disease: laparotomy or not? (letter). Ann Intern Med 76:330-332, 1972 LinkGoogle Scholar4. GLATSTEINGUERNSEYROSENBERG EJS: The value of laparotomy and splenectomy in the staging of Hodgkin's disease. Cancer 24:709-718, 1969 CrossrefMedlineGoogle Scholar5. SALZMANKAPLAN JH: Effect of prior splenectomy on hematologic tolerance during total lymphoid radiotherapy of patients with Hodgkin's disease. Cancer 27:471-478, 1971 CrossrefMedlineGoogle Scholar6. LOWENBRAUNRAMSEYSERPICK SHA: Splenectomy in Hodgkin's disease for splenomegaly, cytopenias and intolerance to myelosuppressive chemotherapy. Am J Med 50:49-55, 1971 CrossrefMedlineGoogle Scholar7. ENRIGHTTRUEBLOODNELSEN LHT: The surgical diagnosis of abdominal Hodgkin's disease. Surg Gynecol Obstet 130:853-858, 1970 MedlineGoogle Scholar8. FERGUSONALLENGRIEM DLM: Surgical experience with laparotomy in 125 patients with lymphoma. Symposium on Hodgkin's disease, St. Louis, Mo., 7-9 October 1971. In press Google Scholar9. HORANCOLEBATCH MJ: Relation between splenectomy and subsequent infection. Arch Dis Child 37:398-414, 1962 CrossrefMedlineGoogle Scholar10. ERAKLISKEVYDIAMOND ASL: Hazard of overwhelming infection after splenectomy in childhood. N Engl J Med 276:1225-1229, 1967 CrossrefMedlineGoogle Scholar11. CASAZZADUVALLCARBONE ACP: Infection in lymphoma. Histology, treatment, and duration in relation to incidence and survival. JAMA 197:710-716, 1966 CrossrefMedlineGoogle Scholar12. DONALDSON S: Personal communication Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Medicine Pritzker School of Medicine Division of Biological Sciences University of Chicago and the Argone Cancer Research Hospital Chicago, Ill.*See also another case reported by Stiver and colleagues in "Bacterial Risk in Staging Splenectomy" in the Letters section of the April issue (Ann Intern Med 76:670, 1972). 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