Strong E B, Rubinstein B, Senders C W
Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, School of Medicine,Sacramento 95817, USA.
Otolaryngol Head Neck Surg. 2001 Nov;125(5):473-7. doi: 10.1067/mhn.2001.119862.
Recent literature has suggested that histopathologic analysis of routine tonsillectomy and adenoidectomy (T&A) specimens may be unnecessary. This study investigates T&A specimen handling practices in the United States between 1989 and 1999.
Surveys were sent to 4715 members of the American Academy of Otolaryngology. Surveys assessed practice type, pathologic processing practices (full, gross, no pathology), and reasons for change. The authors also performed a retrospective analysis of 1583 pediatric T&A specimens for evidence of occult malignancy.
Practice types were 80% private, 12% academic, 6% salaried, and 2% military. Chi squared analysis revealed a significant increase (P < 0.001) in respondents ordering "gross only" and "no pathology." The retrospective analysis found no occult malignancies.
There is a statistically significant increase in the number of otolaryngologists sending routine T&A specimens for "gross only" and "no pathology." There was no correlation between the type of practice and changes in pathologic analysis performed.
近期文献表明,对常规扁桃体切除术和腺样体切除术(T&A)标本进行组织病理学分析可能没有必要。本研究调查了1989年至1999年间美国处理T&A标本的情况。
向美国耳鼻咽喉头颈外科学会的4715名成员发送了调查问卷。调查评估了执业类型、病理处理方法(全面、大体、无病理检查)以及改变的原因。作者还对1583份儿科T&A标本进行了回顾性分析,以寻找隐匿性恶性肿瘤的证据。
执业类型为80%私人执业、12%学术机构、6%受薪、2%军队。卡方分析显示,选择“仅做大体检查”和“不做病理检查”的受访者显著增加(P < 0.001)。回顾性分析未发现隐匿性恶性肿瘤。
将常规T&A标本送去做“仅做大体检查”和“不做病理检查”的耳鼻咽喉科医生数量在统计学上有显著增加。执业类型与所进行的病理分析变化之间没有相关性。