Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management

Abstract Introduction The use of a circular stapling device to create an anastomosis following colonic or rectal resection is common practice in the United Kingdom. Histopathological analysis of the anastomotic doughnuts produced takes time and resources, but does it ever change patient management?...

Full description

Bibliographic Details
Main Authors: Steven Dixon, Hannah Barrow, Jane Hughes
Format: Article
Language:English
Published: BMC 2020-01-01
Series:Surgical and Experimental Pathology
Online Access:https://doi.org/10.1186/s42047-019-0054-7
_version_ 1818967046675759104
author Steven Dixon
Hannah Barrow
Jane Hughes
author_facet Steven Dixon
Hannah Barrow
Jane Hughes
author_sort Steven Dixon
collection DOAJ
description Abstract Introduction The use of a circular stapling device to create an anastomosis following colonic or rectal resection is common practice in the United Kingdom. Histopathological analysis of the anastomotic doughnuts produced takes time and resources, but does it ever change patient management? The aim of this study was to review the examination of doughnuts and whether patient treatment was altered by the findings. Method A retrospective case note review of all cases involving anastomotic doughnuts in a single trust between December 2010 and January 2018, was performed. Results There were 435 cases identified, male to female ratio was 2.0:1, age range 20–86 years and a median age of 66 years. 376 Doughnut samples were received by the pathology department (86.4%) and 354 were examined (81.4%). The disease processes involved were adenocarcinoma (n = 352, 80.9%), diverticular disease (n = 47, 10.8%), no residual disease/complete response (n = 22, 5.1%), adenoma (n = 7, 1.6%), mucinous (n = 5, 1.1%), Crohn’s disease (n = 1, 0.2%) and neuroendocrine (n = 1, 0.2%). Benign adenomatous change was identified in 4 cases (0.9%). No doughnuts examined contained dysplastic or malignant changes. Conclusion The histological examination of anastomotic doughnuts is extremely unlikely to identify malignant change and subsequently does not change patient management. Pathology departments could save time and resources by not routinely examining doughnuts.
first_indexed 2024-12-20T13:42:34Z
format Article
id doaj.art-786bc90d14794b83aecbfb1647bfe244
institution Directory Open Access Journal
issn 2520-8454
language English
last_indexed 2024-12-20T13:42:34Z
publishDate 2020-01-01
publisher BMC
record_format Article
series Surgical and Experimental Pathology
spelling doaj.art-786bc90d14794b83aecbfb1647bfe2442022-12-21T19:38:46ZengBMCSurgical and Experimental Pathology2520-84542020-01-01311410.1186/s42047-019-0054-7Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient managementSteven Dixon0Hannah Barrow1Jane Hughes2Health Education North WestHealth Education North WestAintree University HospitalAbstract Introduction The use of a circular stapling device to create an anastomosis following colonic or rectal resection is common practice in the United Kingdom. Histopathological analysis of the anastomotic doughnuts produced takes time and resources, but does it ever change patient management? The aim of this study was to review the examination of doughnuts and whether patient treatment was altered by the findings. Method A retrospective case note review of all cases involving anastomotic doughnuts in a single trust between December 2010 and January 2018, was performed. Results There were 435 cases identified, male to female ratio was 2.0:1, age range 20–86 years and a median age of 66 years. 376 Doughnut samples were received by the pathology department (86.4%) and 354 were examined (81.4%). The disease processes involved were adenocarcinoma (n = 352, 80.9%), diverticular disease (n = 47, 10.8%), no residual disease/complete response (n = 22, 5.1%), adenoma (n = 7, 1.6%), mucinous (n = 5, 1.1%), Crohn’s disease (n = 1, 0.2%) and neuroendocrine (n = 1, 0.2%). Benign adenomatous change was identified in 4 cases (0.9%). No doughnuts examined contained dysplastic or malignant changes. Conclusion The histological examination of anastomotic doughnuts is extremely unlikely to identify malignant change and subsequently does not change patient management. Pathology departments could save time and resources by not routinely examining doughnuts.https://doi.org/10.1186/s42047-019-0054-7
spellingShingle Steven Dixon
Hannah Barrow
Jane Hughes
Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management
Surgical and Experimental Pathology
title Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management
title_full Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management
title_fullStr Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management
title_full_unstemmed Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management
title_short Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management
title_sort doughnut bother histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management
url https://doi.org/10.1186/s42047-019-0054-7
work_keys_str_mv AT stevendixon doughnutbotherhistopathologicalexaminationofanastomoticdoughnutsfollowingcolorectalanastomosisdoesnotchangepatientmanagement
AT hannahbarrow doughnutbotherhistopathologicalexaminationofanastomoticdoughnutsfollowingcolorectalanastomosisdoesnotchangepatientmanagement
AT janehughes doughnutbotherhistopathologicalexaminationofanastomoticdoughnutsfollowingcolorectalanastomosisdoesnotchangepatientmanagement