Routine histologic examination is unnecessary for tonsillectomy or adenoidectomy
Routine histologic examination is unnecessary for tonsillectomy or adenoidectomy
复制标题
DOI：
10.1097/mlg.0b013e318093ee4e
复制
发表时间：
2007-09-01
期刊：
影响因子：
2.6
通讯作者：
Thompson, Lester D. R.
中科院分区：
文献类型：
--
作者：
Randall, David A.;Martin, Peter J.;Thompson, Lester D. R.
目的：确定目前对扁桃体切除术和腺样体切除术标本进行组织学检查的做法和费用是否合理。研究设计：基于医学文献的综述文章。主题和方法：对所有有关扁桃体切除术、腺样体切除术和相关手术病理学的相关文献进行 PubMed 回顾性综述。对所获得文章的参考文献进行了审查以获取其他来源。结果：20 项研究报告了 54,901 名患者，发现了 54 种恶性肿瘤（患病率 0.087%）。其中，48 例（占患者的 88%）在术前出现可疑特征，例如扁桃体不对称、颈部淋巴结肿大或扁桃体外观异常。其余六名没有任何可疑特征（更好地代表真正的隐匿性恶性肿瘤）的患者占总病例的 0.011%。 结论：只有当患者表现出与恶性肿瘤相关的发现时，才需要提交扁桃体切除术、腺样体切除术或两种标本：扁桃体不对称、癌症史、颈部肿块、扁桃体硬度或病变、体重减轻和全身症状。
Objective: To determine whether the current practice and incurred cost of histologic examination of tonsillectomy and adenoidectomy specimens is warranted.Study Design: Review article based on medical literature.Subjects and Methods: A retrospective PubMed review of all pertinent literature regarding tonsillectomy, adenoidectomy, and related surgical pathology was conducted. References of the articles obtained were reviewed for additional sources.Results: Twenty studies report 54,901 patients and found 54 malignancies (0.087% prevalence). Of these, 48 (88% of the patients) had suspicious features such as tonsillar asymmetry, cervical lymphadenopathy, or abnormal tonsil appearance, preoperatively. The remaining six patients without any suspicious features (better representing true occult malignancy) were 0.011% of the total cases.Conclusion: Submission of tonsillectomy, adenoidectomy, or both specimens is warranted only when patients demonstrate findings associated with malignancy: tonsillar asymmetry, history of cancer, neck mass, tonsil firmness or lesion, weight loss, and constitutional symptoms.