[Diagnostic laparotomy in the child under 12 with Hodgkin's disease]

Twenty-eight children with Hodgkin's disease were followed between 1971 to 1978. Patients were grouped at diagnosis by clinical staging (C.S.) I and II (60%) and III and IV (40%). All patients were laparotomized and splenectomized and multiple node gland biopsy were taken in order to classify them in anatomopathological stages (A.P.S.) and to administer treatment according to a local protocol. No surgical complications were seen and in 10 patients (36%), infiltration of spleen, lymph nodes and other organs were found at surgery which changed their initial clinical stage to a more advanced stage. Then patients (36%) presented 12 episodes of viral infections, during the first years after splenectomy, and 9 bacterial infectious complications mainly between 2 to 4 years after surgery. All patients with A.P.S. I and II are alive and in complete remission, without treatment and with a mean survival time (M.S.T.) of 32 months. M.S.T. in patients with A.P.S. III A has been 63 months and two out of six have died from tumor dissemination and septicemia. M.S.T. in patients A.P.S. III B and IV has been 57 months and 3 out of 11 have died all from dissemination of their disease. Dissemination of the disease, splenectomy and immunologic depression from therapy are important factors to be evaluated when laparotomy is performed in children with Hodgkin's disease.