PRACTICE OF SURGEONS REGARDING EXAMINATION OF PATHOLOGICAL SPECIMENS IN OPERATING ROOM
AbstractBackground: The debate of routine versus selective submission of specimens for histopathologymakes it important to know the present practice of surgeons. The objective of this study was todetermine the proportion of general surgeons examining the gall bladder and appendix specimensin operating room before submission for histopathology. Methods: This questionnaire basedsurvey was conducted for the general surgeons working in the city of Hyderabad, Pakistan duringMay-June 2008. The data was entered and analysed in SPSS 11.0 software statistical program todetermine the impact of designation, hospital category and experience on the responses ofsurgeons. Results: Overall, 42 out of 47 qualified general surgeons working in Hyderabad,Pakistan responded the questionnaire. About 23.8% and 4.8% reported to be always examininggall bladder and appendix specimens respectively in operating room. About 66.7% and 40.5%reported to be submitting every gall bladder and appendix specimen respectively forhistopathology. Lack of practice and poverty were reported as the common causes of notexamining the specimen in operating room and not submitting every specimen for histopathologyrespectively. About 25.8% and 81.8% from public and private sector hospitals respectivelyreported to be submitting every appendix specimen for histopathology. About 88.2% and 52% ofsurgeons having experience of five years or less and experience of more than five yearsrespectively reported to be submitting every gall bladder specimen for histopathology.Conclusions: There is widespread variation in the practice of general surgeons regardingoperating room examination as well as submission of specimens for histopathology.Keywords: General surgeons, Macroscopic examination, Operating room, Histopathology
Anthony PP. A hitchhikers guide to survival in
histopathology. Bull Royal Coll Pathol 1998;101:32–4.
Alun-Jones T, Hill J, Leighton SE, Morrissey MS. Is routine
histological examination of nasal polyps justified? Clin
Otolaryngol Allied Sci 1990;15:217–9.
Brooks SG, Hughes RG. Selective histopathology for
appendix specimens. Lancet 1987;2(8575):1456.
Wenner WJ Jr, Gutenberg M, Crombleholme T, Flickinger C,
Bartlett SP. The pathological evaluation of the pediatric
inguinal hernia sac. J Pediatr Surg 1998;33:717–8.
Cataldo PA, MacKeigan JM. The necessity of routine
pathologic evaluation of hemorrhoidectomy specimens. Surg
Gynecol Obstet 1992;174:302–4.
Raab SS. The cost effectiveness of routine histologic
examination. Am J Clin Pathol 1998;110:391–6.
Wolkomir AF, Barone JE, Moser RL. Selective microscopic
examination of gall bladders, hernia sacs and appendices. Am
Kassan MA, Munoz E, Laughlin A, Margolis IB, Wise L.
Value of routine pathology in herniorrhaphy performed upon
adults. Surg Gynecol Obstet 1986;163:518–22.
Partrick DA, Bensard DD, Karrer FM, Ruyle SZ. Is routine
pathological evaluation of pediatric hernia sacs justified? J
Pediatr Surg 1998;33:1090–2; discussion 1093–4.
Chan W, Fu KH. Value of routine histopathological
examination of appendices in Hong Kong. J Clin Pathol
Fitzgibbons P, Cleary K. CAP offers recommendations on
selecting surgical specimens for examination. CAP Today
Zarbo RJ, Nakhleh RE. Surgical pathology specimens for
gross examination only and exempt from submission: A
College of American Pathologists Q-Probes study of current
policies in 413 institutions. Arch Pathol Lab Med
Cross SS, Stone JL. Proactive management of histopathology
workloads: analysis of the UK Royal College of Pathologists’
recommendations on specimens of limited or no clinical
value on the workload of a teaching hospital gastrointestinal
pathology service. J Clin Pathol 2002;55:850–2.
Royal College of Pathologists. Histopathology and
cytopathology of limited or no clinical value (2nd Ed).
London: Royal College of Pathologists; 2005.
Salmon HA, Smith JH, Balsitis M. Is microscopic assessment
of macroscopically normal hysterectomy specimens
necessary? J Clin Pathol 2000;55:67–8.
Bondeson L, Linell F, Ringberg A. Breast reductions; What
to do with all the tissue specimens. Histopathology
Speake WJ, Abercrombie JF. Should doughnut histology be
routinely performed following anterior resection for rectal
cancer? Ann R Coll Surg Engl 2003;85(1):26–7.
Smoot EC III. Does this go to pathology? Plast Reconstr Surg
Taylor HW, Huang JK. Routine pathological examination of
the gall bladder is a futile exercise. Br J Surg 1998;85:208.
Bazoua G, Hamza N, Lazim T. Do we need histology for a
normal looking gall bladder? J Hepatobiliary Pancreat Surg
Darmas B, Mahmud S, Abbas A, Baker AL. Is there any
justification for the routine histological examination of
straightforward cholecystectomy specimens? Ann R Coll
Surg Engl 2007;89:238–41.
Dix FP, Bruce IA, Krypcyzk A, Ravi S. A selective approach
to histopathology of the gall bladder is justifiable. Surgeon
Matthyssens LE, Ziol M, Barrat C, Champault GG. Routine
surgical pathology in general surgery. Br J Surg
Royal College of Pathologists. Histopathology of limited or
no clinical value. Report of working group of the Royal
College of Pathologists. London: Royal College of
Samad A. Gall bladder carcinoma in patients undergoing
cholecystectomy for cholelithiasis. J Pak Med Assoc
J Ayub Med Coll Abbottabad 2009;21(4)
Akyurek N, Irkorucu O, Salman B, Erdem O, Sare M,
Tatlicioglu E. Unexpected gall bladder cancer during
laparoscopic cholecystectomy. J Hepatobiliary Pancreat Surg
Perpetuo MD, Valdivieso M, Heilbrun LK, Nelson RS,
Connor T, Bodey GP. Natural history study of gall bladder
cancer: a review of 36 years experience at M.D. Anderson
Hospital and Tumor Institute. Cancer 1978;42:330–5.
Henson DE, Albores-Saavedra J, Corle D. Carcinoma of the
gall bladder. Histologic types, stage of disease, grade and
survival rates. Cancer 1992;70:1493–7.
Marudanayagam R, Williams GT, Rees BI. Review of the
pathological results of 2660 appendicectomy specimens. J
Jones AE, Phillips AW, Jarvis JR, Sargen K. The value of
routine histopathological examination of appendicectomy
specimens. BMC Surg 2007;7:17.
Gilmore OJ, Browett JP, Griffin PH, Ross IK, Brodribb AJ,
Cooke TJ. Appendicitis and mimicking conditions. A
prospective study. Lancet 1975;2:421–4.
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