Clinicopathological Correlation of Non Oncological Hysterectomies at a Tertiary Healthcare Centre
Introduction: Hysterectomy is a common surgical procedure for benign gynaecologic pathologies despite the availability of conservative treatment options. However, studies indicate many health and psychosexual complications following this procedure. Regular histopathological audit of hysterectomi...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Pvt. Ltd.
2022-07-01
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| Series: | National Journal of Laboratory Medicine |
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| Online Access: | https://www.njlm.net/articles/PDF/2643/54846_CE[Ra1]_F[SH]_PF1(SG_SHU)_redo_PFA(SHU)_PB(SG_SHU)_PN(SHU).pdf |
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| author | KALPANA SHARMA |
| author_facet | KALPANA SHARMA |
| author_sort | KALPANA SHARMA |
| collection | DOAJ |
| description | Introduction: Hysterectomy is a common surgical procedure
for benign gynaecologic pathologies despite the availability
of conservative treatment options. However, studies indicate
many health and psychosexual complications following this
procedure. Regular histopathological audit of hysterectomies in
relation to the clinical rationale will provide valuable data and
insight and thus, lead to improved knowledge and expertise.
Aim: To correlate clinical and histopathological diagnosis in
hysterectomies for non oncological indications and assess the
agreement between the two modalities.
Materials and Methods: A retrospective cross-sectional study
with comparative clinicopathological analysis which included 702
hysterectomies for non oncological indications during a one-year
period (April 2019 to March 2020) was carried out in the Department
of Pathology at a tertiary healthcare centre in Ajmer, Rajasthan,
India. Cohen-kappa value was determined to measure the degree
of agreement between clinical and histopathological diagnosis. A
comparative clinicopathological analysis was done by segregating
cases into two categories-those with structural pathologies and
the other with non structural/functional pathologies.
Results: A total of 702 hysterectomy specimens were
studied. The clinicopathological concordance for structural
lesions was better than functional aetiologies (87.52% vs
57.8%). Leiomyoma was the most frequent clinical and
histopathological diagnosis. Histopathology revealed more
structural lesions than clinically suspected (81.2% vs 75.36%).
The Cohen-kappa value revealed an overall fair agreement
between clinical and histopathological judgement (κ=0.27).
Clinicopathological-agreement was lower in adenomyosis,
dual structural pathologies while it was better for polyps,
leiomyomas, obstetric pathologies and procidentia.
Conclusion: Although, an overall fair degree of agreement
was found between clinical and histopathological diagnosis,
conditions that lack a specific clinical presentation or a
sensitive diagnostic test like adenomyosis showed poor
clinicopathological agreement. Histopathology is a vital
tool to verify the appropriateness of the clinical indication of
hysterectomies. Frequent clinicopathological correlation helps
in improving knowledge and expertise of the healthcare provider,
thus improving future clinical judgements. |
| first_indexed | 2024-04-11T06:30:50Z |
| format | Article |
| id | doaj.art-94dd7e13d78b4cb983b61bd1abb6eb70 |
| institution | Directory Open Access Journal |
| issn | 2277-8551 2455-6882 |
| language | English |
| last_indexed | 2024-04-11T06:30:50Z |
| publishDate | 2022-07-01 |
| publisher | JCDR Research and Publications Pvt. Ltd. |
| record_format | Article |
| series | National Journal of Laboratory Medicine |
| spelling | doaj.art-94dd7e13d78b4cb983b61bd1abb6eb702022-12-22T04:40:03ZengJCDR Research and Publications Pvt. Ltd.National Journal of Laboratory Medicine2277-85512455-68822022-07-01113404510.7860/NJLM/2022/54846.2643Clinicopathological Correlation of Non Oncological Hysterectomies at a Tertiary Healthcare CentreKALPANA SHARMA0Associate Professor, Department of Pathology, J.L.N Medical College, Ajmer, Rajasthan, India.Introduction: Hysterectomy is a common surgical procedure for benign gynaecologic pathologies despite the availability of conservative treatment options. However, studies indicate many health and psychosexual complications following this procedure. Regular histopathological audit of hysterectomies in relation to the clinical rationale will provide valuable data and insight and thus, lead to improved knowledge and expertise. Aim: To correlate clinical and histopathological diagnosis in hysterectomies for non oncological indications and assess the agreement between the two modalities. Materials and Methods: A retrospective cross-sectional study with comparative clinicopathological analysis which included 702 hysterectomies for non oncological indications during a one-year period (April 2019 to March 2020) was carried out in the Department of Pathology at a tertiary healthcare centre in Ajmer, Rajasthan, India. Cohen-kappa value was determined to measure the degree of agreement between clinical and histopathological diagnosis. A comparative clinicopathological analysis was done by segregating cases into two categories-those with structural pathologies and the other with non structural/functional pathologies. Results: A total of 702 hysterectomy specimens were studied. The clinicopathological concordance for structural lesions was better than functional aetiologies (87.52% vs 57.8%). Leiomyoma was the most frequent clinical and histopathological diagnosis. Histopathology revealed more structural lesions than clinically suspected (81.2% vs 75.36%). The Cohen-kappa value revealed an overall fair agreement between clinical and histopathological judgement (κ=0.27). Clinicopathological-agreement was lower in adenomyosis, dual structural pathologies while it was better for polyps, leiomyomas, obstetric pathologies and procidentia. Conclusion: Although, an overall fair degree of agreement was found between clinical and histopathological diagnosis, conditions that lack a specific clinical presentation or a sensitive diagnostic test like adenomyosis showed poor clinicopathological agreement. Histopathology is a vital tool to verify the appropriateness of the clinical indication of hysterectomies. Frequent clinicopathological correlation helps in improving knowledge and expertise of the healthcare provider, thus improving future clinical judgements.https://www.njlm.net/articles/PDF/2643/54846_CE[Ra1]_F[SH]_PF1(SG_SHU)_redo_PFA(SHU)_PB(SG_SHU)_PN(SHU).pdfadenomyosisbenign gynaecologic pathologieshistopathological auditleiomyomapolyps |
| spellingShingle | KALPANA SHARMA Clinicopathological Correlation of Non Oncological Hysterectomies at a Tertiary Healthcare Centre National Journal of Laboratory Medicine adenomyosis benign gynaecologic pathologies histopathological audit leiomyoma polyps |
| title | Clinicopathological Correlation of Non Oncological Hysterectomies at a Tertiary Healthcare Centre |
| title_full | Clinicopathological Correlation of Non Oncological Hysterectomies at a Tertiary Healthcare Centre |
| title_fullStr | Clinicopathological Correlation of Non Oncological Hysterectomies at a Tertiary Healthcare Centre |
| title_full_unstemmed | Clinicopathological Correlation of Non Oncological Hysterectomies at a Tertiary Healthcare Centre |
| title_short | Clinicopathological Correlation of Non Oncological Hysterectomies at a Tertiary Healthcare Centre |
| title_sort | clinicopathological correlation of non oncological hysterectomies at a tertiary healthcare centre |
| topic | adenomyosis benign gynaecologic pathologies histopathological audit leiomyoma polyps |
| url | https://www.njlm.net/articles/PDF/2643/54846_CE[Ra1]_F[SH]_PF1(SG_SHU)_redo_PFA(SHU)_PB(SG_SHU)_PN(SHU).pdf |
| work_keys_str_mv | AT kalpanasharma clinicopathologicalcorrelationofnononcologicalhysterectomiesatatertiaryhealthcarecentre |