Role of surgeons in determining outcome of histopathology specimens

In the changing world of clinicopathologic practice where surgeons and pathologists are faced with increasing therapeutic demands, precise demands of each group from the other have often been reduced to blames and counter-blames. This study is thus aimed at auditing the current practice of specimen handling as a means of highlighting areas where mutual best practice is required.

A total of 200 specimens and 100 separate request cards received over the 3 months were audited for: Use of fixative, adequacy of fixative used, types of specimen containers and appropriate labeling of containers. The request cards were audited for: Documentation of patients' hospital numbers, ages, histories of disease, sites of biopsy, examination findings, investigations done, provisional diagnosis and concordance of clinical diagnosis with histopathological diagnosis.

About 20% of specimens were unfixed, 23.5% had inadequate fixative, 16.5% were in inappropriate containers and 32.5% were incompletely labeled respectively. In 25%, 50% and 53% of forms the age, clinical history and examination findings respectively were not documented. Provisional diagnosis was in concordance with eventual histological diagnosis in 69% of cases.

To ensure the quality of histopathological diagnosis with minimal turnaround time, the surgeon plays a vital role by ensuring adequate and prompt fixation of tissue biopsies, put in the right container and accompanied by well labeled request cards.