Patel Jaison, Jenkins Stephanie
Princess Alexandra Hospital, Harlow, United Kingdom.
Ann Med Surg (Lond). 2016 Feb 24;7:7-8. doi: 10.1016/j.amsu.2016.02.012. eCollection 2016 May.
With new breast conserving oncological surgical techniques, accurate identification of specimen margins is important to allow for the re-excision of margins. The accurate identification of margins is crucial is the success of the patients treatment if further margins are required. NHS Breast Screening Programme (NHSBSP) guidelines recommend the excised specimen is labelled accurately to correctly identify the margins and allow for X-ray examination. This method has been proven to be cheap, it uses equipment and materials readily available in the operating theatre. Furthermore, if any of the methods fails as there is more than one way to identifying your margins. For example if a clip were to fall off, the type/length of suture and the orientation on the board will still allow you to identify the correct margin. If the sample was to fall off the board, the sutures and clips will still allow the pathologist to orientate the sample. In summary this method is easy to apply, logical and uses equipment readily available within the theatre, i.e. silk sutures, and the needle protection board. It ensures all relevant radiological and surgical criteria are met for enabling orientation of the specimen when removed from the breast tissue. It is an easily taught technique that is easy to remember. A national survey showed a lack and wide variation of specimen orientation protocols. (Volleamere et al., 2013) This technique could be used as the national standard for breast specimen marking and as a national marking system for the NHS.
随着新的保乳肿瘤外科技术的出现,准确识别标本切缘对于再次切除切缘至关重要。如果需要进一步切除切缘,准确识别切缘对于患者治疗的成功至关重要。英国国家医疗服务体系乳房筛查计划(NHSBSP)指南建议对切除的标本进行准确标记,以正确识别切缘并进行X线检查。这种方法已被证明成本低廉,它使用手术室中 readily available 的设备和材料。此外,如果其中任何一种方法失败,因为识别切缘有不止一种方法。例如,如果一个夹子掉落,缝线的类型/长度以及在板上的方向仍将使您能够识别正确的切缘。如果样本从板上掉落,缝线和夹子仍将使病理学家能够确定样本的方向。总之,这种方法易于应用、合乎逻辑且使用手术室中 readily available 的设备,即丝线缝线和针保护板。它确保满足所有相关的放射学和手术标准,以便在从乳腺组织中取出标本时能够确定标本的方向。这是一种易于教授且容易记住的技术。一项全国性调查显示,标本定向方案存在不足且差异很大。(Volleamere等人,2013年)这种技术可以用作乳腺标本标记的国家标准以及NHS的国家标记系统。 (注:“readily available”直译为“随时可用的”,结合语境这里意译为“现成的”更合适,但题目要求不添加解释,所以保留原文)