Breast Specimen Orientation
Breast Specimen Orientation
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DOI：
10.1245/s10434-008-0245-z
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发表时间：
2009-02-01
影响因子：
3.7
通讯作者：
Avisar, E.
中科院分区：
文献类型：
--
作者：
Molina, M. A.;Snell, S.;Avisar, E.
肿瘤切除标本通常分为六面：浅面、深面、上面、下面、内侧和外侧。在手术过程中在标本上放置定向缝线，以便通过病理学重新定向。尽管做出了这些努力，样本仍可能会迷失方向。本研究的目的是评估外科医生和病理学家之间取向的相关性。肿块切除标本按常规定向。外科医生在一侧随机放置一条额外的 Prolene 缝合线，以通过病理学定位。记录结果并计算迷失率。还记录了样本大小以及皮肤和/或肌肉的存在。前瞻性输入了 122 个肿瘤切除标本。平均样本体积为 95.5 cm(3)。二十四个样本有皮肤或肌肉片段。额外的缝合线均匀地分布在六个侧面之间。总体迷失方向率为31.1%（95%置信区间，23.1-40.2）。深层、浅表、外侧、内侧、上、下表面的侧面特异性迷失率分别为43%、40%、35%、29%、28%和14%（无统计学差异）。样本上皮肤或肌肉的存在并不能有助于更好的定向。然而，样本体积与方向高度相关。 < 20 cm(3) 的样本的定向障碍率为 78%，而较大样本的定向障碍率为 20% (p < .001)。将缝线放置在两个表面上的样本定向与高定向障碍率相关。需要更好的定向技术来最大限度地减少样本的定向障碍。
Lumpectomy specimens are commonly divided into six sides: superficial, deep, superior, inferior, medial, and lateral. Orienting stitches are placed on the specimen during surgery to allow reorientation by pathology. Despite those efforts, specimen disorientation may occur. The aim of this study was to assess the correlation in orientation between surgeons and pathologists. Lumpectomy specimens were routinely oriented. An additional Prolene suture was randomly placed by the surgeon on one side to be localized by pathology. The results were recorded and the disorientation rate calculated. Specimen size and presence of skin and/or muscle were also recorded. There were 122 lumpectomy specimens prospectively entered. Average specimen volume was 95.5 cm(3). Twenty-four specimens had segments of skin or muscle. The additional sutures were evenly divided between the six sides. The overall disorientation rate was 31.1% (95% confidence interval, 23.1-40.2).The side-specific disorientation rates were 43%, 40%, 35%, 29%, 28%, and 14% for the deep, superficial, lateral, medial, superior, and inferior surfaces, respectively (no statistical difference). Presence of skin or muscle on the specimen did not contribute to better orientation. Specimen volumes, however, were highly associated with orientation. Specimens of < 20 cm(3) had a disorientation rate of 78%, while larger specimen had a disorientation rate of 20% (p < .001). Specimen orientation with stitches placed on two surfaces is associated with a high disorientation rate. Better orientation techniques are necessary to minimize the specimen disorientation.