Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Research Article Volume 7 Issue 1

Is Routine Histopathological Evaluation of Stapler Doughnuts Obtained During Anterior Resection Justified? An Attempt to Answer Million Dollar Question

Varsha Chowdary1, Steffi Dcruz2* and Badareesh L3

1Resident, Department of Surgery, Kasturba Medical College, Manipal Academy of Higher Education, India
2Assistant Professor, Department of Surgery, Kasturba Medical College, Manipal Academy of Higher Education, India 3Professor and Unit head, Department of Surgery, Kasturba Medical College, Manipal Academy of Higher Education, India

*Corresponding Author: Steffi Dcruz, Assistant Professor, Department of Surgery, Kasturba Medical College, Manipal Academy of Higher Education, India.

Received: October 30, 2023; Published: December 13, 2023

Abstract

Aim: To assess the outcome of routine histopathological evaluation of stapler doughnuts obtained during anterior resection of recto sigmoid segment and bearing of doughnut positivity on eventual treatment plan for the patient. Material and methods: A prospective observational single centre study conducted at Kasturba Hospital, Manipal, for 2 years from December 2020 to October 2022. Study includes all the patients who underwent anterior resection with stapled, circular, end-to-end colo-rectal anastomosis (CEEA) for Carcinoma rectum.

Results: A total of 27 cases were recruited and both proximal and distal doughnuts were sent for histopathological evaluation in all the cases. Of all the 27 cases in the study, all the resection margins and doughnuts were reported to be negative for malignancy.

Conclusion: Doughnut histology had no bearing on the following course of treatment or the prognosis of the illness and clinical judgments were not revised in response to doughnut histology. There is a lack of advantage in routinely sending doughnuts for HPE in all circumstances. They can be sent only when the chance of a positive margin is thought to be higher without having a negative impact on patient care.

Keywords: Carcinoma Rectum; Anterior Resection; Circular end to end Anastomosis Stapler Device (CEEA); Stapler Doughnuts

References

  1. Ho Y-H and Ashour MAT. “Techniques for colorectal anastomosis”. World Journal of Gastroenterology 16 (2010): 1610-1621.
  2. Speake WJ and Abercrombie JF. “Should 'doughnut' histology be routinely performed following anterior resection for rectal cancer?” Annals of the Royal College of Surgeons of England 1 (2003): 26-27.
  3. Ng CW., et al. “Routine histological sampling of doughnuts post oncologic anterior resection is not necessary”. International Journal of Colorectal Disease 7 (2014): 843- 845.
  4. Morgan A., et al. “Histological examination of circular stapled 'doughnuts': questionable routine practice?” Surgeon2 (2006): 75-77.
  5. Surgue J., et al. “No clinical benefit from routine histologic examination of stapler doughnuts at low anterior resection for rectal cancer”. Surgery1 (2017): 147-151.
  6. Dixon S., et al. “Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management”. Surgical and Experimental Pathology 2 (2020).
  7. Haq I., et al. “Benefits of Outcomes of the Microscopic Examination of Anastomotic Donuts After Colorectal Resection for Oncological Purposes: A Medical Record-Based Study”. Cureus5 (2020): e7932.
  8. Expert Advisory Group to the Royal College of Surgeons of England and the Association of Coloproctology. “Guidelines of the management of colorectal cancer”. The Royal College of Surgeons of England, London (1996).

Citation

Citation: Steffi Dcruz., et al. “Is Routine Histopathological Evaluation of Stapler Doughnuts Obtained During Anterior Resection Justified? An Attempt to Answer Million Dollar Question".Acta Scientific Gastrointestinal Disorders 7.1 (2024): 16-18.

Copyright

Copyright: © 2024 Steffi Dcruz., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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