Is routine pathologic evaluation of hemorrhoidectomy specimens necessary?
OBJECTIVE
To confirm that systematic histological study of hemorrhoidectomy specimens is useless, as is proposed by the French Society of Coloproctology (Société Nationale Française de Colo-Proctologie) under the sponsorship of the French National Health Accreditation and Evaluation Agency (Agence Nationale d'Accréditation et d'Evaluation en Santé).


METHODS
Retrospective histological analysis of hemorrhoidectomy specimens obtained in a coloproctology unit between January 1, 1985 and December 31, 2001.


RESULTS
We found 56 histological abnormalities (0.69%) among 8153 hemorrhoidectomy specimens considered normal at gross examination, with three cases of intraepithelial neoplasia of the anal canal (0.04%) and four cases of severe dysplasia (0.05%). Specimens associated with anal fissure (N = 906) or suppuration (N = 610) did not display more histological lesions. For all patients, the initial surgical resection prevented recurrence.


CONCLUSIONS
Routine pathological evaluation of hemorrhoidectomy specimens is not useful and is expensive. All operating procedures in proctology should reflect this attitude. It is nevertheless advisable to select for gross and microscopic evaluation any suspicious areas noticed at the preoperative examination or during the procedure.
Lemarchand
Nicolas
N
Service de colo-proctologie, Hôpital Léopold Bellan, 19/21 rue Vercingetorix, 75014 Paris. nlemarchand@noos.fr
Tanne
Florence
F
Aubert
Manuel
M
Benfredj
Paul
P
Denis
Jean
J
Dubois-Arnous
Noëlle
N
Fellous
Katia
K
Ganansia
Roland
R
Senejoux
Agnès
A
Soudan
Denis
D
Puy-Montbrun
Thierry
T
D000328:Adult; D003955:Diagnostic Tests, Routine; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012002:Rectal Diseases / Q000473:pathology; D012189:Retrospective Studies