title: Long-term morbidity after staging laparotomy for Hodgkin lymphoma.
abstract: BACKGROUND
  A large cohort of Hodgkin lymphoma (HL) survivors exist. With patients transitioning from pediatric to adult care, practitioners should be aware of potential complications. The aim of this study was to describe the long-term complications of patients who had staging laparotomy for the treatment of HL.
  
  
  METHODS
  After institutional review board approval, a retrospective review of hospital records at our institution was performed. Data extracted included demographics, treatment course and long-term postoperative complications.
  
  
  RESULTS
  24 patients with HL underwent staging laparotomy from 1971 to 1994 with median follow-up of 27.9years. Six (33%) had intraabdominal disease. Three patients (17%) required four repeat laparotomies for bowel obstruction. Of these, one had radiation to the inguinal region for local control, one had mantle radiation. Five patients developed a second malignancy. There were no documented cases of postsplenectomy sepsis. Other late effects that were unlikely related to surgery included pulmonary fibrosis (4), heart failure (2), hypothyroidism (4), and dysphagia (3). One patient died of metastatic adenocarcinoma.
  
  
  CONCLUSIONS
  Long-term follow-up of patients who underwent staging laparotomy for HL revealed an increased incidence of repeat laparotomy and secondary malignancy. This underscores the importance of a high index of suspicion and screening in this population.
  
  
  METHODS
  Level III.
authors.affiliation: Division of Pediatric and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
authors.forename: Inna
authors.initials: I
authors.lastname: Lobeck
authors.affiliation: Division of Pediatric and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
authors.forename: Beth
authors.initials: B
authors.lastname: Rymeski
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Childrens Hospital Medical Center, Cincinnati, OH USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Burns
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Childrens Hospital Medical Center, Cincinnati, OH USA.
authors.forename: Rajaram
authors.initials: R
authors.lastname: Nagarajan
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Childrens Hospital Medical Center, Cincinnati, OH USA.
authors.forename: Judy
authors.initials: J
authors.lastname: Correll
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Childrens Hospital Medical Center, Cincinnati, OH USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Kent
authors.affiliation: Division of Pediatric and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States. Electronic address: Roshni.Dasgupta@cchmc.org.
authors.forename: Roshni
authors.initials: R
authors.lastname: Dasgupta
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006689:Hodgkin Disease / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D007813:Laparotomy / Q000706:statistics & numerical data; D008297:Male; D016609:Neoplasms, Second Primary / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors; D060305:Transition to Adult Care / Q000706:statistics & numerical data*
keywords: Hodgkin lymphoma; Pediatric cancer; Secondary malignancy; Staging laparotomy; Survivorship