Abstract：
Intestinal lymphomas can rarely present as abdominal catastrophes with perforation or small bowel obstruction. There is little data regarding their optimal surgical management and associated outcomes. We aimed to systematically review relevant published literature to assess the presentation, diagnosis, optimal surgical approach and associated post-operative outcomes. A systematic on-line literature search of Embase and Medline identified 1485 articles of which 34 relevant studies were selected, including 7 retrospective studies, 1 case series and 26 case reports. Selected articles were assessed by two reviewers to extract data. 95 patients with abdominal catastrophes secondary to lymphoma (predominately Burkitt (28 %) and Diffuse Large B-cell lymphoma (29 %)) were identified with a median age of 52 years, 40 % were female. Of the small bowel resections 25% (n = 18) suffered post-operative complications with a 13.8 % (n = 10) 30-day mortality. Ileocolonic resections had a 27 % complication rate with 18 % mortality and primary repair had a 25 % complications rate and 25 % mortality. Median follow-up was 8 days (range 1-96). Notable points of differences in the presentations between these different lymphomas included the majority of Burkitt\'s lymphoma were younger, had a known diagnosis, were on chemotherapy and presented with perforation in contrast to those with B cell lymphoma who were predominately older, had new diagnoses and presented with a balanced proportion of obstruction and perforation. Abdominal catastrophes secondary to intestinal lymphomas most commonly present with perforation. Aggressive surgical management, including small bowel resection, may offer similar remission rates for lymphoma patients presenting with abdominal catastrophes as those without such emergency complications.
摘要：
肠淋巴瘤很少表现为腹部病变伴穿孔或小肠梗阻。关于他们的最佳手术管理和相关结果的数据很少。我们旨在系统地回顾相关已发表的文献，以评估演示文稿，诊断,最佳手术方式和相关的术后结果。对Embase和Medline进行了系统的在线文献检索，确定了1485篇文章，其中34篇相关研究被选中。包括7项回顾性研究，1例病例系列和26例病例报告。选定的文章由两名审阅者评估以提取数据。95例继发于淋巴瘤（主要是伯基特（28％）和弥漫性大B细胞淋巴瘤（29％））的腹部病变患者的中位年龄为52岁，40%是女性。在小肠切除术中，有25％（n=18）的术后并发症，30天死亡率为13.8％（n=10）。回结肠切除术的并发症发生率为27％，死亡率为18％，初次修复的并发症发生率为25％，死亡率为25％。中位随访时间为8天（范围1-96）。这些不同淋巴瘤之间表现的显著差异包括大多数伯基特淋巴瘤较年轻，有一个已知的诊断，与主要年龄较大的B细胞淋巴瘤患者相比，正在进行化疗并出现穿孔，有新的诊断，并呈现均衡比例的梗阻和穿孔。继发于肠淋巴瘤的腹部灾难最常见于穿孔。积极的手术管理，包括小肠切除术,对于出现腹部灾难的淋巴瘤患者，可以提供与没有这种紧急并发症的患者相似的缓解率。
