Does everything a surgeon takes out have to be seen by a pathologist? A review of the current pathology practice

Abstract

Histopathologic examination of surgically removed tissues and organs is an important aspect of modern hospital quality health care. Most surgical specimens deserve to be submitted for pathologic examination, which may yield valuable new information relevant for the future treatment of the patient. A small number of specimens, recognized as providing limited or no valuable clinical data during pathologic examination, may be placed on the list of specimens "exempt from submission" or those that are labeled as "for gross examination only." Guidelines written by the committees of the national regulatory organizations provide general orientation on how to deal with various specimens, but the final decision on which type of specimen to eliminate and which ones to include for pathologic examination rests on local governing and advisory bodies of each institution. Particular lists of specimens exempt from pathologic examination are best generated through a consensus agreement of clinical and laboratory physicians. Even though there is general nationwide and even international consensus on which types of specimens deserve pathologic examination and which do not, there are still discussions about the necessity of some pathologic examinations.

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“…Histopathologic examination is essential for identifying tumors, guiding tumor treatment and evaluating the prognosis. 1,2 The classical examination method involves hematoxylin and eosin (H&E) staining, which requires sectioning the tissue and observing the changes in cell morphology with an optical microscope. 3 This method relies heavily on the experience of the observer, resulting in a potential lack of diagnostic accuracy.…”

Routine evaluation of tonsillectomy specimens: A cross-sectional survey of Canadian Otolaryngology: Head and Neck Surgeons

“…However, automatically sending all surgical specimens for analysis is a resource-intensive practice. Many centers no longer suggest routine analysis of specimens unless the results of analysis are likely to change patient care [ 3 , 6 , 7 ].…”

Histopathological Account of Obstetrical and Gynecological Specimens: Retrospective Study at a Tertiary Care Center of Peshawar

“…Histopathologic specimen examination of surgically isolated organs and tissues plays a crucial role in the confirmation of a diagnosis. Most surgical specimens need to be submitted for further histopathological analysis, as it may yield valuable information relevant for the future management of the patient [ 1 ]. The College of American Pathologists has presented specific guidelines for specimen collection and submission and has given an account of the specimens that can be excluded from being sent for histopathology [ 2 ].…”

“…Even though there is nationwide and international consensus on which types of specimens deserve pathologic examination and which do not, there are still discussions about the necessity of some pathologic examinations [ 1 ]. Pakistan being an underdeveloped country, not many people can afford surgeries, and then the added routine examination without an indication can be an extra burden for the patient and their family.…”