膀胱颈挛缩切除术后常规组织病理学检查的必要性

M. Kaynar, M. Gul, Mustafa Kucur, E. Çelik, M. Bugday, S. Goktas
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Patient demographics, type of surgery and histopathological diagnosis and cost of histopathological analyses of the specimens were recorded and analyzed. Results Findings of the histopathologic evaluations of 340 bladder neck specimens were reviewed. Out of these, 294 had underwent transurethral resection of the prostate, 38 open prostatectomy, and 8 radical prostatectomy. Evidence of malignant disease involving prostate cancer was present in only 2 specimens. Both of the specimens had a known preexisting history of malignant disease. The remaining 338 specimens showed chronic inflammation (n = 176), chronic active inflammation (n = 64), adenomatous hyperplasia (n = 78) or cystitis (n = 20). Conclusions Our results indicate that routine histopathological examination of bladder neck contraction specimens is clinically unnecessary. 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引用次数: 18

摘要

膀胱颈挛缩是一些泌尿外科手术后常见的并发症。无论采用何种手术方法,切除的任何标本都应在全球范围内提交组织病理学评估。然而,组织病理学评估的费用可能会给医院和卫生保健系统带来沉重的负担。此外,等待病理评估过程的时期可能是一个焦虑的时间为患者。因此,我们旨在探讨膀胱颈部挛缩标本常规组织病理学评估的必要性。材料与方法选取2010 ~ 2015年行膀胱颈收缩切除术的患者。记录和分析患者人口统计学、手术类型和组织病理学诊断以及标本组织病理学分析的费用。结果回顾了340例膀胱颈部标本的组织病理学检查结果。其中294例行经尿道前列腺切除术,38例行开放性前列腺切除术,8例行根治性前列腺切除术。恶性疾病的证据涉及前列腺癌只有2个标本。这两个标本都有已知的恶性疾病病史。其余338例为慢性炎症(176例)、慢性活动性炎症(64例)、腺瘤性增生(78例)或膀胱炎(20例)。结论膀胱颈收缩标本的常规病理检查在临床上是不必要的。我们建议外科医生应根据已知的术前危险因素,根据个体情况决定是否需要进行组织学检查。
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Necessity of routine histopathological evaluation subsequent to bladder neck contracture resection
Introduction Bladder neck contracture is a well-known complication following some urologic surgical procedures. Regardless of the surgical procedure, any specimen resected should be submitted for histopathological evaluation worldwide. However, the charges of histopathological evaluation may bring a heavy burden to the hospital and health care system. Also, waiting the period of the pathological evaluation process can be an anxious time for patients. Hence, we aimed to investigate the necessity of routine histopathological evaluation of bladder neck contracture bladder neck contraction specimens. Material and methods Patients undergoing bladder neck contraction resection, from 2010 to 2015 were identified. Patient demographics, type of surgery and histopathological diagnosis and cost of histopathological analyses of the specimens were recorded and analyzed. Results Findings of the histopathologic evaluations of 340 bladder neck specimens were reviewed. Out of these, 294 had underwent transurethral resection of the prostate, 38 open prostatectomy, and 8 radical prostatectomy. Evidence of malignant disease involving prostate cancer was present in only 2 specimens. Both of the specimens had a known preexisting history of malignant disease. The remaining 338 specimens showed chronic inflammation (n = 176), chronic active inflammation (n = 64), adenomatous hyperplasia (n = 78) or cystitis (n = 20). Conclusions Our results indicate that routine histopathological examination of bladder neck contraction specimens is clinically unnecessary. We recommend that the surgeon should decide the need for histological examination on individual basis, depending on known preoperative risk factors.
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