结肠直肠手术后甜甜圈常规组织病理学分析的成本效益 三年单中心经验

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2024-08-19 eCollection Date: 2024-01-01 DOI:10.1155/2024/9837336
Masood Ur Rehman, Reem Moussa, Cindy Siaw Lin, Naeem Ahmed, Abdul Rehman, Kamran Malik, Jamil Ahmed
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引用次数: 0

摘要

目的:本研究旨在评估对接受直肠癌手术(RCS)的患者进行常规结直肠吻合口活检组织学检查的影响。活检检查的合理性可成为英国国家医疗服务体系(NHS)净零实践战略的一部分,努力减少浪费和碳足迹:方法:我们对本研究所 2019-2021 年期间接受直肠癌手术的所有患者进行了数据分析。我们还分析了准备和审查组织学切片的成本:结果:52 名患者在上述期间接受了前部切除术。37例(71%)患者送去了甜甜圈。23例(62%)患者为男性,14例(38%)为女性。确诊时的中位年龄为 68 岁(54-84 岁)。所有切除标本均为腺癌。在37名患者中,18人(49%)接受了低位前切除术,19人(51%)接受了高位前切除术。26例(70%)患者接受了近端切除,而所有病例都接受了远端切除。肿瘤远端显微切除边缘平均为 22 毫米(范围为 6-45 毫米)。每个甜甜圈需要 3 张切片,每张 50 英镑,固定和读片需要 82 分钟。这需要 13,650 英镑的成本和 19,656 小时的准备时间。所有切片以及切除边缘的恶性肿瘤均为阴性:甜甜圈的常规组织病理学检查需要大量时间和成本,但几乎没有临床价值(尤其是对近端甜甜圈的分析)。只有在特殊情况下,才应将远端甜甜圈送去进行组织病理学检查。
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Cost-Effectiveness of Routine Histopathological Analysis of Doughnuts after Colorectal Surgery Three-Year Single-Centre Experience.

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.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
期刊最新文献
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