Intraoperative frozen section consultation- an audit in a tertiary care hospital

Abstract

Introduction: Frozen section (FS) helps the surgeon in the surgical management of the patient by helping in the intraoperative diagnosis of tumors, margins and lymphnode assessment, and organ identification. Audits of the frozen section consultations help in identifying the pitfalls and to carry out appropriate preventive measures for its optimal usage. We report the results of the study of our FS consultations. Materials and Methods: A retrospective study of 518 specimens from 132 consecutive cases of FS consultations was carried out. The FS report and formalin fixed tissue reports were compared and analyzed. The results were categorized into concordant, discordant and deferred consultations. Causes of discrepancy were analysed and diagnostic accuracy, diagnostic error rates, sensitivity, specificity, indications, tissue type, turnaround time and limitations were noted. Results: An average of 3.92 specimens per patient was received with 80(60.61%) males and 52(39.39%) females. Age ranged from 15 to 80 years. Male and female general surgical departments were the major contributors with 64 (48.48%) and 25 (18.94%) consultations respectively. Oropharyngolaryngeal region (48.84%) was the main site sampled. The main indication was margin status assessment (52.27%). Accuracy rate was 98.65% with an error rate of 1.35% was observed. The discordant cases had misinterpretation error in 5 cases and sampling errors in the remaining 2 cases. Three cases (0.58%) were deferred. Sensitivity (90.91%) and specificity (96.59%) was obtained. Conclusions:The study turned out as a quality check and identified the areas requiring improvement to reduce the error rates.

Analysis of frozen section compared to permanent section: a 2 year study in a single teritiary care hospital

“…The frozen section is a valuable rapid diagnostic tool to assist the surgeon in intraoperative management of surgical procedures by avoiding second surgery and it is of valuable help to the surgeon when there is good communication with pathologists in understanding the surgical implications of the case. 9 It is costly and requires skill in technique as well as interpretation. Hence this facility is mostly located in major hospitals.…”

“…In an audit of intraoperative frozen section consultation, Satish S et al 9 found that sampling errors of nondiagnostic areas intraoperatively was the reason for the sampling errors (1.51%) and interpretation errors were 3.79%, which were attributed to sectioning artifacts, lack / poor quality of morphological details, and presence of the diagnostic area only in the deeper sections. They also noted that technical errors such as sectioning, staining, and labeling may also occur.…”