Surgery in the management of Hodgkin's disease

Twenty patients with advanced Hodgkin's disease and evidence of secondary hypersplenism were treated by splenectomy. Seven patients died in the postoperative period. Uncontrollable hemorrhage and postoperative infection were the causes of this high operative mortality. Eight of the 13 survivors showed a beneficial hematologic response postsplenectomy. In 5 of these further treatment of their Hodgkin's disease by chemotherapy was made possible. Of the 13 survivors 10 were dead of their disease within 6 months of surgery and only one patient lived longer than 12 months. Unlike some of the other lymphomas and chronic leukemias, secondary hypersplenism occurs late in the course of Hodgkin's disease and, as a result, splenectomy will benefit only the occasional patient.