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Is routine histopathological examination of appendectomy specimens useful? A systematic review of the literature.
MedLine Citation:
PMID:  20958910     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aim  Histopathological examination of the appendix after appendectomy is routinely performed. The object of this systematic review is to determine whether routine histopathological examination of the appendix is justified. Method  PubMed, EMBASE, Web of Science and the Cochrane library were searched without language restriction up to 1 October 2009. All articles that reported on the incidence of histopathologically proven aberrant appendiceal pathology were included. Results  Nineteen case series reported the incidence of a benign neoplasm [0.5%, weighted mean (WM)], malignant neoplasm (0.2%, WM) and other pathology (0-14%). Nine articles reported the sensitivity of the intra-operative findings to detect aberrant diagnoses. Parasitic infection was detected in 0-19%, endometriosis in 0% and granulomatosis in 0-11% of cases. Five articles addressed the consequences of aberrant pathology. Most patients with parasite infection, granulomatosis and malignant neoplasms underwent additional investigation or treatment, in contrast to patients with a benign neoplasm. Conclusion  The incidence of unexpected findings in appendectomy specimens is low and the intra-operative diagnosis alone appears insufficient for identifying unexpected disease. The benefit of histopathology is studied inadequately. From the present available evidence, routine histopathology cannot be judged as useless.
Authors:
H A Swank; E J Eshuis; D T Ubbink; W A Bemelman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  13     ISSN:  1463-1318     ISO Abbreviation:  Colorectal Dis     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  1214-21     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.
Affiliation:
Department of Surgery, Academic Medical Centre, Amsterdam, the Netherlands Department of Clinical Epidemiology and Biostatistics and Surgery, Academic Medical Centre, Amsterdam, the Netherlands.
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