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Cost-Effectiveness of Routine Histopathological Analysis of Doughnuts after Colorectal Surgery Three-Year Single-Centre Experience.

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اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: Wiley Country of Publication: United States NLM ID: 101566285 Publication Model: eCollection Cited Medium: Internet ISSN: 2090-1410 (Electronic) Linking ISSN: 20901402 NLM ISO Abbreviation: Int J Surg Oncol Subsets: MEDLINE
    • بيانات النشر:
      Publication: 2024- : [Hoboken, NJ] : Wiley
      Original Publication: New York, NY : Hindawi Pub. Corp.
    • الموضوع:
      Cost-Benefit Analysis* ; Rectal Neoplasms*/surgery ; Rectal Neoplasms*/pathology ; Rectal Neoplasms*/economics; Humans ; Female ; Male ; Middle Aged ; Aged ; Aged, 80 and over ; Adenocarcinoma/surgery ; Adenocarcinoma/pathology ; Adenocarcinoma/economics ; Margins of Excision ; Retrospective Studies ; Anastomosis, Surgical/economics
    • نبذة مختصرة :
      Aim: This study aimed to assess the impact of routine histological examination of stapled colorectal anastomotic doughnuts in patients undergoing rectal cancer surgery (RCS). Justification of biopsy examination could form part of the strategies of NHS net zero practice with effort to reduce wastage and carbon footprint.
      Method: A data analysis of all patients undergoing RCS during 2019-2021 at our institute was performed. We also analysed the cost of preparing and reviewing histology slides.
      Results: 52 patients underwent anterior resection during the aforementioned period. Doughnuts were sent in 37 (71%) patients. 23 (62%) patients were male, and 14 (38%) were female. The median age at diagnosis was 68 (range 54-84) years. All resected specimens were adenocarcinomas. Of the 37 patients, 18 (49%) underwent low anterior resection and 19 (51%) underwent high anterior resection. Proximal doughnuts were sent in 26 (70%) patients, whereas distal doughnuts were sent in all cases. Mean distal microscopic resection margin from tumour was 22 mm (range 6-45 mm). Each doughnut required 3 slides, each costing £50 and requiring 82 minutes to fix and read. This incurred a cost of £13,650 and required 19,656 hours of preparation time. All of the doughnuts as well as resection margins were negative for malignancy.
      Conclusion: Routine histopathological examination of doughnuts is time and cost-intensive however provides little or no clinical value (particularly analysis of the proximal doughnut). Distal doughnuts should only be sent for histological examination in exceptional circumstances.
      Competing Interests: The authors declare that there are no conflicts of interest.
      (Copyright © 2024 Masood Ur Rehman et al.)
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    • الموضوع:
      Date Created: 20240827 Date Completed: 20240827 Latest Revision: 20240828
    • الموضوع:
      20250114
    • الرقم المعرف:
      PMC11347031
    • الرقم المعرف:
      10.1155/2024/9837336
    • الرقم المعرف:
      39188852