Ullah Ammara Saif, Mushtaq Reemal, Mehmood Qadri Haseeb, Saeed Hasan, Sheraz Muhammad, Nizami Muhammad Faraz K, Waheed Saba, Ijaz Momin, Fatima Warda, Saeed Maha
Surgery, Lahore General Hospital, Lahore, PAK.
Surgery, Jinnah Hospital, Lahore, PAK.
Cureus. 2023 Dec 10;15(12):e50270. doi: 10.7759/cureus.50270. eCollection 2023 Dec.
Background Histopathology of a tissue specimen plays a crucial role in formulating the final diagnosis of any disease. It confirms whether the histopathological findings are in correspondence with the clinical diagnosis and thus suggests an optimal management plan. Standard surgical practices guide that every human tissue specimen must undergo postoperative tissue analysis unless indicated otherwise. Objective To determine the significance of histopathology in determining the final diagnosis of appendectomy specimens. Materials and methods This retrospective clinical study conducted in May 2022 included 100 patients operated for appendectomy from January 1, 2021, to December 31, 2021, in the emergency room of the Department of General Surgery, Unit-III, Lahore General Hospital, Lahore. Data were retrieved from patients' records and the picture archiving and communication system (PACS). A Google Forms-based (Google, Mountain View, CA) was generated to include the demographic details, clinical manifestations, and histopathology reports of the patients. Descriptive analysis was completed using a Microsoft Excel spreadsheet (Microsoft Corporation, Redmond, WA). Results Fifty-two patients were females out of the total 100. The mean age at presentation was 23.02 ± 12.02 years. Of the samples, 54% were not sent for histopathology. Among the remaining ones, 27% of cases were proven to be acute appendicitis. Alvarado score was 7-10 in 50% of patients. Other lesions proven by histopathology were appendiceal phlegmon (4%), perforated appendix (4%), mucocele (1%), carcinoid tumor (1%), tuberculosis (1%), and adenocarcinoma (1%). Conclusions Histopathological analysis is the gold standard for the tissue diagnosis of a disease. The high percentage of the samples not sent for histopathology is alarming since the appendix is not only a site for inflammatory pathologies but for neoplastic lesions as well. This practice depicts that the incidence of non-inflammatory pathologies is being ignored by healthcare professionals and there is a dire need to emphasize the significance of acquiring histopathology reports for the specimens of appendectomy in all circumstances.
背景 组织标本的组织病理学在任何疾病的最终诊断中都起着至关重要的作用。它能确认组织病理学检查结果是否与临床诊断相符，从而提出最佳治疗方案。标准外科操作指南规定，除非另有指示，每个人体组织标本都必须进行术后组织分析。
目的 确定组织病理学在阑尾切除标本最终诊断中的意义。
材料与方法 这项回顾性临床研究于2022年5月进行，纳入了2021年1月1日至2021年12月31日在拉合尔综合医院第三单元普通外科急诊室接受阑尾切除术的100例患者。数据从患者记录和图像存档与通信系统（PACS）中获取。生成了一份基于谷歌表单（谷歌，加利福尼亚州山景城）的表格，用于录入患者的人口统计学细节、临床表现和组织病理学报告。使用微软Excel电子表格（微软公司，华盛顿州雷德蒙德）完成描述性分析。
结果 在总共100例患者中，52例为女性。就诊时的平均年龄为23.02±12.02岁。其中，54%的样本未送去做组织病理学检查。在其余样本中，27%的病例被证实为急性阑尾炎。50%的患者阿尔瓦拉多评分在7 - 10分。组织病理学证实的其他病变包括阑尾蜂窝织炎（4%）、阑尾穿孔（4%）、黏液囊肿（1%）、类癌肿瘤（1%）、结核病（1%）和腺癌（1%）。
结论 组织病理学分析是疾病组织诊断的金标准。未送去做组织病理学检查的样本比例很高，这令人担忧，因为阑尾不仅是炎症性病变的发生部位，也是肿瘤性病变的发生部位。这种做法表明医疗专业人员忽视了非炎症性病变的发生率，迫切需要强调在所有情况下获取阑尾切除标本组织病理学报告的重要性。
