Pullyblank A M, Kirwan C, Rigby H S, Dixon A R
Department of General Surgery, Frenchay Hospital, Bristol, UK.
Colorectal Dis. 2001 May;3(3):198-200. doi: 10.1046/j.1463-1318.2001.00235.x.
'Doughnuts' of colonic tissue which remain on a circular stapler after firing are routinely examined histologically. However, Royal College of Pathologists' guidelines state that this is not necessary. The aim of this study was to examine current practice among pathologists in one region in the UK and to determine the incidence of clinically significant pathology within colonic doughnuts.
Current practice in all pathology Departments within the South-west Region was examined and 100 doughnuts from anterior resection specimens were reviewed for the presence of abnormal pathology.
Practice varied between hospitals with only 15% following guidelines for examination of doughnuts and 38% following guidelines for reporting of resection margins. Review of pathology specimens demonstrated no incidence of colonic adenocarcinoma in a doughnut. Benign pathology was present in 9% and dysplasia in 3% but in no case was patient management altered as a result of the pathology report.
Application of recommended guidelines is inconsistent. We have demonstrated a low incidence of clinically significant pathology in doughnuts and more economical guidelines could therefore be safely applied without detriment to patient care.
环形吻合器击发后留在上面的结肠组织“标本圈”通常要进行组织学检查。然而，皇家病理学家学会的指南指出这并无必要。本研究的目的是调查英国一个地区病理学家的当前做法，并确定结肠标本圈中具有临床意义的病理情况的发生率。
对西南地区所有病理科的当前做法进行了调查，并对100份前切除术标本的标本圈进行了检查，以查看是否存在异常病理情况。
不同医院的做法各不相同，只有15%的医院遵循标本圈检查指南，38%的医院遵循切缘报告指南。病理标本检查显示，标本圈中未发现结肠腺癌。良性病理情况占9%，发育异常占3%，但无一例患者的治疗因病理报告而改变。
推荐指南的应用并不一致。我们已证明标本圈中具有临床意义的病理情况发生率较低，因此可以安全地应用更经济的指南，而不会对患者护理造成不利影响。
