[The use of laparoscopy for diagnosis and stadiation of the lymphomas]

Abstract

Aim: To evaluate feasibility, safety and effectiveness of laparoscopic biopsies in the diagnosis and stadiation of intraabdominal lymphadenopathy.

Material of study: From January 2005 to December 2006 12 patients (5 males, 7 females, age 31-54, average 43) with intra-abdominal lymphadenopathy were admitted to our institution (V Chirurgia Generale Ospedale Ferrarotto Catania) to perform laparoscopic biopsies. Indication to treatment was primary diagnosis in ten patients and restaging in two cases. Laparoscopic procedure was performed with a three-trocars technique also using an ultrasound laparoscopic probe.

Results: All cases were completed laparoscopically (conversion rate nil). Mean operation time: 35 min. All patients were discharged from hospital the day after the procedure. There were no complications. In all cases laparoscopic biopsies provided adequate tissue for correct diagnosis and complete immune-histochemical assessment (11 Lymphoma H, 1 Lymphoma NH).

Discussion: Today surgery has a new important role in the diagnosis and stadiation of intraabdominal lymphadenopathy. Imaging such as TC-RM and Surgery Radiology Techniques (fine needle aspiration and core needle biopsy) are frequently inadequate to diagnosis and show a worse diagnostic accuracy than laparoscopic biopsies. Our limited experience in accordance with major literature reports demonstrate laparoscopic procedure is really effective and safe.

Conclusion: Laparoscopic lymph node biopsy safely provides adequate tissue for full histological evaluation in patients with intra-abdominal lymphadenopathy adding the advantages of "miniinvasive" techniques.