Quality assessment of intraoperative frozen sections: An analysis of 261 consecutive cases in a resource limited area: Morocco

Chbani, Laïla; Mohamed, S.; Harmouch, T.; Fatemi, Hinde El; Amarti, Afaf

doi:10.4236/health.2012.47068

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…No attempt was made to assess the difference in accuracy rate of the various pathologists. (3) 2 100 96.9 3.1 Roy S et al; (9) 9 months 327 97.6 2.4 Shreshtha S et al; (11) 5 404 94.6 5.4 Chbani et al; (12) 1…”

Section: Resultsmentioning

confidence: 99%

“…The discordant rates in various studies range from 1.4% to 12.9% from different anatomical sites and the present study had a comparable data (Table 5). 3,4,11,12 Errors may occur in any one of the multiple steps involved right from the specimen surgical resection, transportation, tissue processing, slide reporting till the report communication and discordant results are usually attributed to both interpretation and sampling errors, followed by technical errors such as sectioning, staining, and labelling. 4,9 In our study interpretation errors (3.79%) were the most frequently observed and was attributed to sectioning artefacts (freezing and folding), lack/poor quality of morphological details and presence of the diagnostic area only in the deeper sections (Fig.…”

Section: Discussionmentioning

confidence: 99%

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

2020

IJPO

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

2020

IJPO

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“…In present study, diagnosis was deferred in one cases which is comparable to previously published studies with a deferred rate ranging from 0.04% to 6.7%. 7 The deferred case was of previously operated case of pituitary adenoma, the lesion was recurred so frozen section was performed, which showed only haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of frozen section: an institutional observational study

Mohite,

Joshi,

Bhardwaj

2024

Int J Res Med Sci

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Background: Frozen section is an important tool in rapid intra-operative diagnosis. It is commonly used during surgical procedures to detect malignancy so that modifications of surgery can be decided at the time of surgery on the table. Frozen section is also performed for evaluation of surgical margins and detection of lymph node metastasis. In addition, it is applied for detection of unknown pathological processes. The objective of this study was to assess the accuracy of frozen section diagnosis in comparison to gold standard histopathological diagnosis and to find concordance and discordance rate of frozen section with histopathological report. Aim of the study was comparison between frozen section and routine formalin fixed paraffin sections in various tissues. Methods: This is a retrospective cross-sectional study of 272 frozen section samples done in the department of pathology in Bharati Medical College and Research Centre, Dhankawdi- Pune and Excel diagnostics Pune, in Maharashtra from January 2022 to April 2023. The study included all frozen section samples with their permanent tissue samples received for final histopathological evaluation. Results: Out of 272 cases, 268 had concordant diagnosis on frozen section and permanent paraffin embedded section. Out of 4 discordant cases, 3 showed false negative result and definite diagnosis of one case could not be given on frozen section. The overall diagnostic accuracy of frozen section was 98.52%. Conclusions: Frozen section is a reliable intra operative diagnostic tool. Intra-operative diagnosis helps surgeon to take important intra-operative decision to avoid second surgery. Accuracy of frozen section can be improved by avoiding sampling errors and experience of the histopathologist.

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“…Assessment of nodal status Roy S et al, [7] 65.9% 30.6% --3.8% Patil P et al, [12] 55% 34% --11% Chbani L et al, [14] 85.4% 7.3% 4.3% --White V et al, [15] 41% 26% --28% Saumaya misra et al, Quality of prepared sections during cryostat sectioning plays an important role in FS diagnoses. Technical issues leading to alteration in cytological or architectural features necessary for establishing accurate diagnoses during processing of frozen sectioning may pose difficulty.…”

Section: Identification Of Cellmentioning

confidence: 99%

A study on qualitative comparison between cryostat and conventional technique for histopathology diagnosis

Zinzala

Goswami

et al. 2020

Trop J Pathol Microbiol

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Introduction: Intraoperative consultation by frozen section technique is an invaluable tool for immediate diagnosis. The correlation of intraoperative frozen section diagnosis with final diagnosis on permanent section is an integral part of quality assurance in surgical pathology. Its accuracy and limitations vary with different anatomical sites. Aims & Objective: Qualitative morphological comparison between frozen section and routine formalin fixed paraffin embedded sections in different tissues, to assess the accuracy of frozen section, to detect the number and type of discrepancies and to assess the causes for discrepancies. Material and Method: The present study retrospectively reviewed frozen sections performed in the pathology department, Sirt hospital, government medical college, Bhavnagar during a period of 2 year. Diagnostic accuracy of frozen section and its morphological quality and reliability in comparison to histopathology was evaluated by 2 pathologists in a blinded fashion for the following parameters: cellular outline, nuclear and cytoplasmic features, staining pattern and overall morphology. The results were compared to the routine formalin fixed paraffin sections to evaluate diagnostic accuracy. Discordant cases were reassessed to find the reasons for discrepancy. Result: Diagnostic accuracy of frozen section was 95.1% with false negative case are 4.8% and no false positive case. Statistical analysis showed that most common indications of frozen section in the present study was presence/typing of neoplasm (61.2%) followed by assessment of margin (35.6%) and assessment of nodal status (3.2%). It was observed that nuclear details, cellular outline and overall morphological quality of frozen section was slightly inferior to that of routine histopathology section, however, staining and cytoplasmic details were comparable. The discrepancies were mainly due to technical artefacts (9.7%), sampling error (3.2%) interpretation error (1.6%), and partly due to lack of interdepartmental communication. Conclusion: Frozen section diagnosis is very useful and highly accurate procedure. Gross inspection, sampling by pathologist, frozen complemented with cytological and histological review and intimal cooperation with surgeon can avoid certain limitations and provide rapid, reliable, cost effective information necessary for optimum patient care.

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Quality assessment of intraoperative frozen sections: An analysis of 261 consecutive cases in a resource limited area: Morocco

Cited by 4 publications

References 11 publications

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

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

Diagnostic accuracy of frozen section: an institutional observational study

A study on qualitative comparison between cryostat and conventional technique for histopathology diagnosis

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