Diseases of the colon and rectum · 2015
Prospective Single-Center Observational Study of Routine Histopathologic Evaluation of Macroscopically Normal Hemorrhoidectomy and Fissurectomy Specimens in Search of Anal Intraepithelial Neoplasia.
СтатьяНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Bauer Pierre, Fléjou Jean-François, Etienney Isabelle, Proctological Prospective Diaconesses Group
Аннотация
BACKGROUND: The necessity for routine histopathologic evaluation of hemorrhoidectomy specimens considered free of suspicious areas after careful visual and manual inspection remains controversial.
OBJECTIVE: The purpose of this work was to prospectively study the prevalence of anal intraepithelial neoplasia in macroscopically normal operative specimens.
DESIGN AND PATIENTS: From October 2005 to September 2010, all hemorrhoidectomy and fissurectomy specimens were sent for routine histopathologic analysis.
SETTING: This study was conducted at a tertiary referral center.
MAIN OUTCOME MEASURES: The primary outcome measured was the histopathologic examination of surgical samples.
RESULTS: Among the specimens from 2997 procedures, routine histopathologic evaluation found anal intraepithelial neoplasia in 97 patients (3.2%), despite the fact that visual and manual inspection had determined that the specimens were free of any suspected anal intraepithelial neoplasia or human papillomavirus-related lesion. The pathological diagnoses for these macroscopically normal specimens were AIN1 in 22 (23%) patients, AIN2 in 48 (49%) patients and AIN3 in 27 (28%) patients, making the prevalence of high-grade and low-grade disease 2.5% (anal intraepithelial neoplasia 2/3) and 0.7% (anal intraepithelial neoplasia 1).
LIMITATIONS: This study was limited by being a single-center study.
CONCLUSION: This prospective single-center study demonstrated that the prevalence of infraclinical anal intraepithelial neoplasia in macroscopically normal hemorrhoidectomy and fissurectomy specimens is not negligible (3.2% with 2.5% high-grade disease).
OBJECTIVE: The purpose of this work was to prospectively study the prevalence of anal intraepithelial neoplasia in macroscopically normal operative specimens.
DESIGN AND PATIENTS: From October 2005 to September 2010, all hemorrhoidectomy and fissurectomy specimens were sent for routine histopathologic analysis.
SETTING: This study was conducted at a tertiary referral center.
MAIN OUTCOME MEASURES: The primary outcome measured was the histopathologic examination of surgical samples.
RESULTS: Among the specimens from 2997 procedures, routine histopathologic evaluation found anal intraepithelial neoplasia in 97 patients (3.2%), despite the fact that visual and manual inspection had determined that the specimens were free of any suspected anal intraepithelial neoplasia or human papillomavirus-related lesion. The pathological diagnoses for these macroscopically normal specimens were AIN1 in 22 (23%) patients, AIN2 in 48 (49%) patients and AIN3 in 27 (28%) patients, making the prevalence of high-grade and low-grade disease 2.5% (anal intraepithelial neoplasia 2/3) and 0.7% (anal intraepithelial neoplasia 1).
LIMITATIONS: This study was limited by being a single-center study.
CONCLUSION: This prospective single-center study demonstrated that the prevalence of infraclinical anal intraepithelial neoplasia in macroscopically normal hemorrhoidectomy and fissurectomy specimens is not negligible (3.2% with 2.5% high-grade disease).