在接受因分泌管疾病而进行西格莫切除术的患者中,是否需要进行组织病理学分析? 一个回顾性研究研究
Antonietta Petrusic1, Francesco Mongelli2,3, Flaminia Sabbatini2
1Department of Surgery, Lugano Regional Hospital EOC, Lugano, Switzerland.
常规组织病理学在分泌管疾病中进行西格莫切除术的结肠镜检查后显示出高一致性. 意想不到的发现很少发生,这表明所有患者可能不需要进行例行检查.
科学领域:
- 胃肠病学 胃肠病学
- 手术病理学手术病理学
- 结肠直肠手术 结肠直肠手术
背景情况:
- 椎病是一种常见的疾病,需要手术干预,通常是西格莫切除术.
- 术前结肠镜检查是标准实践,用于排除在西格莫切除术前的恶性瘤.
- 结肠镜检查后手术样本的常规组织病理学检查的作用需要评估.
研究的目的:
- 评估常规组织病理学检查西格莫切除样本的实用性.
- 为了比较组织病理学发现与手术前结肠镜检查结果在分泌管疾病患者.
主要方法:
- 对207名患者的回顾性分析,这些患者接受了前科全镜 (2013-2023) 进行的分泌管疾病的西格莫切除术.
- 收集了手术前,手术内和手术后的数据.
- 主要终点:与结肠镜相比,意外异常组织病理的患者百分比.
主要成果:
- 结肠镜检查与组织病理学之间具有很高的一致性 (古德曼和克鲁斯卡尔的G指数=0.953).
- 只有3.9%的病例出现了意想不到的发现:2.4%的多发性息肉,1.0%的低度发育不良,0.5%的扩散性大B细胞淋巴瘤.
- 单一的高风险发现 (淋巴瘤) 发生在一个有病史的患者身上.
结论:
- 术前结肠镜可靠地预测分泌管疾病的西格莫切除样本中的组织病理发现.
- 常规组织病理学检查可能对所有患者来说都不具有成本效益或必要.
- 根据患者病史和结肠镜检查结果,可以考虑选择性组织病理学检查.
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