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Related Experiment Videos

Routine surgical pathology in general surgery.

L E Matthyssens1, M Ziol, C Barrat

  • 1Department of General and Digestive Surgery, Université Paris-XIII, Paris, France. vesalius2@yahoo.com

The British Journal of Surgery
|February 14, 2006
PubMed
Summary
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Routine histopathological examination of certain surgical specimens, like those from appendectomies and hernia repairs, may be unnecessary. Macroscopic examination by surgeons and pathologists could suffice, reducing costs and improving efficiency.

Area of Science:

  • General Surgery
  • Pathology
  • Surgical Oncology

Background:

  • Histopathological analysis is standard for surgical resection specimens.
  • Routine pathological examination may be omitted for select, common surgical samples.
  • Evaluating the utility of routine histopathology in daily surgical practice is crucial.

Purpose of the Study:

  • To assess the value of routine histopathological examination in general surgical practice.
  • To determine if histopathological analysis is necessary for specific common specimens.
  • To evaluate the impact of routine histopathology on patient management and healthcare costs.

Main Methods:

  • Retrospective analysis of specimens from appendectomies, cholecystectomies, haemorrhoidectomies, and inguinal hernia repairs (1993-2002).

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  • Comparison of histological and macroscopic diagnoses.
  • Review of preoperative/peroperative findings and assessment of routine histopathology's impact on patient management and costs.

    • Main Results:

    • 100% submission rate for routine pathological evaluation, except for hernia specimens.
    • No aberrant histological findings in over 2000 hernia sac specimens.
    • Malignancies in haemorrhoidectomy specimens (3/311) and relevant incidental findings in appendices (1/1465) were rare and often macroscopically suspected. Adenomas (0.6%) and carcinomas (0.4%) in cholecystectomy specimens were macroscopically identified or associated with known disease.

    Conclusions:

    • Routine histological examination of certain specimens, particularly those without macroscopic abnormalities, may be safely omitted.
    • Macroscopic examination by the surgeon and pathologist can play a more significant role.
    • This approach could streamline diagnostic processes and potentially reduce healthcare costs.