The primary role of surgery in low-grade lymphomas is to obtain a biopsy specimen. Surgery is

a beneficial component of indolent lymphoma treatment in a minority of cases such as in relieving mechanical obstruction caused by lymphoma (e.g. an acute bowel obstruction in duodenal follicular lymphoma).

Splenectomy is an important therapeutic option for SMZL (see 4.2.3 Systemic therapy).

Documented evidence of the surgeon’s training and experience, including their relevant organ- specific sub-specialty experience with low-grade lymphomas and procedures to be undertaken, should be available.

Health service characteristics

To provide safe and quality care for patients having surgery, health services should have these features:

• critical care support
• 24-hour medical staff availability
• 24-hour operating room access and intensive care unit
• diagnostic imaging
• pathology
• PET