Is routine histopathological analysis of hemorrhoidectomy specimens necessary? A systematic review and meta-analysis.
World J Surg
; 48(8): 1981-1989, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-38797982
ABSTRACT
BACKGROUND:
Hemorrhoidectomy is a common procedure used to treat symptomatic hemorrhoids. However, the necessity and cost-effectiveness of routinely conducting histopathological analysis on excised tissue samples are uncertain.METHODS:
A systematic review was conducted using MEDLINE and EMBASE up to December 2023 for studies assessing the histopathological outcomes of hemorrhoidectomy specimens. Meta-analysis was performed on articles with combinable results to determine the pooled proportions of cancer and anal intraepithelial neoplasia (AIN) using the random effects model.RESULTS:
From 2974 initial search results, 12 studies were included in the review, with 48,365 resected specimens from hemorrhoidectomy. Among these, there were 11 retrospective studies and one prospective study. A meta-analysis of 11 studies revealed that the prevalence of anal cancer was low, at 0.13% (95% CI 0.05%-0.31%). The prevalence of anal cancer and AIN combined was 1.16% (95% CI 0.53%-2.52%).CONCLUSION:
This literature review estimated the probability of malignancy detection in hemorrhoid specimens sent for histopathological evaluation. The low incidence of malignant findings implies that routine analysis of hemorrhoidectomy samples may not be cost-effective. However, existing studies have yet to establish definitive risk factors for abnormal histological diagnoses to aid in the selection of specimens for selective histopathology.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Neoplasias del Ano
/
Hemorreoidectomía
/
Hemorroides
Límite:
Humans
Idioma:
En
Revista:
World J Surg
Año:
2024
Tipo del documento:
Article
País de afiliación:
Nueva Zelanda