Value of laparoscopic staging for Hodgkin disease

Because of the potential for complications with laparotomy and splenectomy, and the widespread use of combination chemotherapy as first-line treatment, surgical staging is now performed in only 30% of patients with Hodgkin disease. Laparoscopic staging has rarely been reported. Three patients with the nodular sclerosis cell type of Hodgkin disease underwent laparoscopic staging. Mean operative time was 207 minutes. No conversion to laparotomy was necessary. There were no peri- or postoperative complications and no deaths. Mean blood loss was negligible. The pathologist deemed all liver and lymph nodes biopsies adequate for histologic analysis. Stage IA and IIA were confirmed in two patients: one patient with stage IIA was upstaged to IIIA after surgery. Performed by an experienced team, laparoscopy is the procedure of choice for abdominal staging of patients with Hodgkin disease.