Khalabazyane Baidar, Rashid Rahel, Mclaren Laura, Salah Roza, Kadhmawi Israa, Philips Joshua
Urology, Royal Bournemouth Hospital, Bournemouth, GBR.
General and Colorectal Surgery, Arrowe Park Hospital, Wirral, GBR.
Cureus. 2024 Aug 4;16(8):e66151. doi: 10.7759/cureus.66151. eCollection 2024 Aug.
Background Circumcision is a widely performed surgical procedure all over the globe. This can be for religious, cultural, or medical reasons. Routine histological examination of circumcision specimens is a standard practice in many healthcare systems, despite the relatively low incidence of premalignant or malignant lesions. The primary objective of this study was to evaluate the necessity of routine histopathological examination of foreskin specimens following adult circumcision. Secondary objectives included determining the frequency of malignancy in these specimens, comparing malignancy rates between clinically suspicious and non-suspicious cases, and assessing the correlation between preoperative clinical suspicion and histopathological findings. Aim This study aimed to evaluate the necessity of routine histopathological evaluation for the foreskin after circumcision. We investigated the frequency of malignancy upon histopathological examination, in clinically suspicious cases compared to non-suspicious cases. Method A retrospective observational study was conducted at the Royal Bournemouth Hospital, analyzing data from 334 consecutive adult male patients who underwent circumcision between January 2012 and December 2016. The cohort was retrospectively divided into two groups: those with preoperative suspicious clinical features and those without it. Clinical records on electronic patient records (EPR) were used for follow-up and to identify the percentage of malignancy after final histopathological examinations in both groups. Results Among the 334 patients, only nine patients (2.7%) were deemed as having suspicious clinical features preoperatively, of which, only three (0.9% of the total study sample) showed malignancy upon histological examination. The other six patients in this group were found to have balanitis xerotica obliterans (BXO). The other 325 patients (97.3%) were without clinically suspicious lesions preoperatively, and none were found to have any malignant lesions upon histopathological examination. Conclusion The low incidence of malignancy in circumcision specimens indicates that routine histological examination may not be essential for all cases. Among 334 samples, only three (0.9%) were malignant, and all were clinically suspected. Routine histopathological examination of the remaining 331 cases did not impact management or follow-up. Selectively submitting specimens for histology based on clinical suspicion could reduce opportunity costs and time, optimize resource allocation, and maintain appropriate diagnostic evaluation.
包皮环切术是全球广泛开展的外科手术。其实施原因可能是宗教、文化或医学方面的。在许多医疗体系中，尽管癌前病变或恶性病变的发生率相对较低，但对包皮环切术标本进行常规组织学检查仍是标准做法。本研究的主要目的是评估成人包皮环切术后对包皮标本进行常规组织病理学检查的必要性。次要目的包括确定这些标本中恶性肿瘤的发生率，比较临床可疑病例与非可疑病例的恶性肿瘤发生率，并评估术前临床怀疑与组织病理学结果之间的相关性。
本研究旨在评估包皮环切术后对包皮进行常规组织病理学评估的必要性。我们调查了组织病理学检查时恶性肿瘤的发生率，比较了临床可疑病例与非可疑病例的情况。
在皇家伯恩茅斯医院进行了一项回顾性观察研究，分析了2012年1月至2016年12月期间连续334例接受包皮环切术的成年男性患者的数据。该队列被回顾性地分为两组：术前有可疑临床特征的患者和没有可疑临床特征的患者。利用电子病历（EPR）中的临床记录进行随访，并确定两组最终组织病理学检查后恶性肿瘤的百分比。
在334例患者中，只有9例（2.7%）术前被认为具有可疑临床特征，其中只有3例（占研究总样本的0.9%）在组织学检查时显示为恶性肿瘤。该组中的其他6例患者被发现患有闭塞性干燥性龟头炎（BXO）。其他325例患者（97.3%）术前没有临床可疑病变，组织病理学检查未发现任何恶性病变。
包皮环切术标本中恶性肿瘤发生率较低，这表明常规组织学检查可能并非对所有病例都必不可少。在334个样本中，只有3例（0.9%）为恶性，且均为临床怀疑病例。对其余331例病例进行常规组织病理学检查并未影响治疗或随访。根据临床怀疑选择性地送检标本进行组织学检查可以降低机会成本和时间，优化资源分配，并维持适当的诊断评估。
