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Routine histopathologic examination of “benign” anal lesions: is it necessary?

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Abstract

Purpose

To establish the necessity of routine histopathologic examination of specimens from hemorrhoids and anal fistula that are diagnosed preoperatively.

Methods

We reviewed histopathologic reports from hemorrhoidectomy and anal fistula excision operations performed between 2007 and 2011 in the sixth affiliated hospital of Sun Yat-sen University and Guangdong Province Traditional Chinese Medical Hospital. We evaluated the incidence of unexpected pathologic malignancy and its impact on postoperative management.

Results

Among the 10532 patients recruited, 8308 had undergone hemorrhoidectomy and 2224 had undergone excision of an anal fistula. Unexpected pathologic malignancy was discovered in 17 specimens (0.16 %). Overall and subgroup analysis for risk factors of malignant detection revealed unexpected pathologic malignancy was more likely to be found in people over the age of 60 years (OR = 5.516, P = 0.002 overall and OR = 5.442, P = 0.007 for hemorrhoids).

Conclusion

Routine histopathologic examination of specimens from patients undergoing hemorrhoid or anal fistula surgery is of value for identifying unexpected pathologic malignancy. An age older than 60 years may be a remarkable risk factor.

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References

  1. Matthyssens LE, Ziol M, Barrat C, Champault GG. Routine surgical pathology in general surgery. Br J Surg. 2006;93(3):362–8.

    Article  CAS  PubMed  Google Scholar 

  2. Smoot ER. Does this go to pathology? Plast Reconstr Surg. 1988;81(5):809.

    Article  PubMed  Google Scholar 

  3. Strobel SL. Enhancing the pathologist’s role at hospital tumor boards. Ann Clin Lab Sci. 2006;36(3):243–7.

    PubMed  Google Scholar 

  4. Murata T. Pathology service and practice: solo-practice pathologist in a community hospital in Japan: personal experience and a proposal for cost- and time-effective practice. Pathol Int. 2006;56(8):480–3.

    Article  PubMed  Google Scholar 

  5. Swank HA, Eshuis EJ, Ubbink DT, Bemelman WA. Is routine histopathological examination of appendectomy specimens useful? a systematic review of the literature. Colorectal Dis. 2011;13(11):1214–21.

    Article  CAS  PubMed  Google Scholar 

  6. Fitzgibbons P, Cleary K. CAP offers recommendations on selecting surgical specimens for examination. CAP Today. 1996;10(7):40.

    CAS  PubMed  Google Scholar 

  7. Miller GG, McDonald SE, Milbrandt K, Chibbar R. Routine pathological evaluation of tissue from inguinal hernias in children is unnecessary. Can J Surg. 2003;46(2):117–9.

    PubMed Central  PubMed  Google Scholar 

  8. McKeon K, Boyer MI, Goldfarb CA. Use of routine histologic evaluation of carpal ganglions. J Hand Surg Am. 2006;31(2):284–8.

    Article  PubMed  Google Scholar 

  9. Erdag TK, Ecevit MC, Guneri EA, Dogan E, Ikiz AO, Sutay S. Pathologic evaluation of routine tonsillectomy and adenoidectomy specimens in the pediatric population: is it really necessary? Int J Pediatr Otorhinolaryngol. 2005;69(10):1321–5.

    Article  PubMed  Google Scholar 

  10. Cross SS, Stone JL. Proactive management of histopathology workloads: analysis of the UK Royal College of Pathologists’ recommendations on specimens of limited or no clinical value on the workload of a teaching hospital gastrointestinal pathology service. J Clin Pathol. 2002;55(11):850–2.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Lohsiriwat V, Vongjirad A, Lohsiriwat D. Value of routine histopathologic examination of three common surgical specimens: appendix, gallbladder, and hemorrhoid. World J Surg. 2009;33(10):2189–93.

    Article  PubMed  Google Scholar 

  12. Chan W, Fu KH. Value of routine histopathological examination of appendices in Hong Kong. J Clin Pathol. 1987;40(4):429–33.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Modlin IM, Sandor A. An analysis of 8305 cases of carcinoid tumors. Cancer. 1997;79(4):813–29.

    Article  CAS  PubMed  Google Scholar 

  14. Maqbool A, Lintner R, Bokhari A, Habib T, Rahman I, Rao BK. Anorectal melanoma—3 case reports and a review of the literature. Cutis. 2004;73(6):409–13.

    PubMed  Google Scholar 

  15. Smith DN, Cataldo PA. Perianal lymphoma in a heterosexual and nonimmunocompromised patient: report of a case and review of the literature. Dis Colon Rectum. 1999;42(7):952–4.

    Article  PubMed  Google Scholar 

  16. Ky A, Sohn N, Weinstein MA, Korelitz BI. Carcinoma arising in anorectal fistulas of Crohn’s disease. Dis Colon Rectum. 1998;41(8):992–6.

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

We declare no conflict of interest. This study was sponsored by National Natural Science Foundation of China (91029702) and “985 project” of Sun Yat-sen University and Guangdong Translational Medicine Public Platform (4202037).

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Authors and Affiliations

  1. Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, 26 Yuancun Erheng Rd, Guangzhou, 510655, China

    Xiaosheng He, Zexian Chen, Lei Lian, Senmao Li, Santosh Rouniyar, Yufeng Chen, Xiaojian Wu & Ping Lan

  2. Department of Geriatrics, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Juanni Huang

  3. Department of Anal Surgery, Guangdong Province Traditional Chinese Medical Hospital, Guangzhou, China

    Jinbin Yao

Authors
  1. Xiaosheng He
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  2. Juanni Huang
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  3. Jinbin Yao
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  4. Zexian Chen
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  5. Lei Lian
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  6. Senmao Li
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  7. Santosh Rouniyar
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  8. Yufeng Chen
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  9. Xiaojian Wu
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  10. Ping Lan
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Corresponding author

Correspondence to Ping Lan.

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He, X., Huang, J., Yao, J. et al. Routine histopathologic examination of “benign” anal lesions: is it necessary?. Surg Today 45, 416–421 (2015). https://doi.org/10.1007/s00595-014-1090-2

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  • DOI: https://doi.org/10.1007/s00595-014-1090-2

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