title: Is routine pathologic evaluation of hemorrhoidectomy specimens necessary?
abstract: 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.
authors.affiliation: Service de colo-proctologie, Hôpital Léopold Bellan, 19/21 rue Vercingetorix, 75014 Paris. nlemarchand@noos.fr
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lemarchand
authors.forename: Florence
authors.initials: F
authors.lastname: Tanne
authors.forename: Manuel
authors.initials: M
authors.lastname: Aubert
authors.forename: Paul
authors.initials: P
authors.lastname: Benfredj
authors.forename: Jean
authors.initials: J
authors.lastname: Denis
authors.forename: Noëlle
authors.initials: N
authors.lastname: Dubois-Arnous
authors.forename: Katia
authors.initials: K
authors.lastname: Fellous
authors.forename: Roland
authors.initials: R
authors.lastname: Ganansia
authors.forename: Agnès
authors.initials: A
authors.lastname: Senejoux
authors.forename: Denis
authors.initials: D
authors.lastname: Soudan
authors.forename: Thierry
authors.initials: T
authors.lastname: Puy-Montbrun
mesh_terms: 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