Routine pathologic evaluation of hemorrhoidectomy and fistulectomy specimens: Are they worth while?

ABSTRACT

Unsuspected carcinoma of the anus found on routine pathologic analysis of specimens taken at hemorrhoidectomy is a rare occurence. During the past two years, 200 hemorrhoidectomies and Fistulectomies have been performmed at NASR CITY hospital for health Insurance and at SAUDI Hospital During that time period, only one istance of unsuspected carcinoma of the anus was diagnosed solely by microscopic analysis of a specimen that was taken a hemorrhoidectomy. Used on this information, slective rather routine pathologic evaluation of hemorrhoidectomy and fistulectomy specimens all patients should undergo careful anorectal examination prior to operation repeated examination should be performed with the patient under anesthesia and all excised tissue should be visually and manually inspected by the operating surgeon. Any suspicious areas will be sent for pathologic evaluation. The coincidence of hemorrhoids with cancer rectum is not uncommon. In the past the fear of missing an incidental anal neoplasm prejudiged many surgeons against non operative treatment of hemorrhoid Presently, the majority of patients with symptomatic hemorrhoids are treated nonoperatively, yet there have been no reports of these patients having subsequent carcinoma of the anus flap. Thus after exclusion of those patients with secondary hemorrhoids due to cancer rectum or sigmoid Routine pathologic examination is expensive this has led to the Question is routine pathologic evaluation of hemorrhoidectomy and fistulectomy specimens necessary? To answer this question the present study was done