Browsing by Author "Deodhar, KK"

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    An audit of frozen sections for suspected gastrointestinal malignancies in a tertiary referral hospital in India
    (Wolters Kluwer - Medknow, 2022-12) Jadhav, AS; Deodhar, KK; Ramadwar, M; Bal, M; Kumar, R; Goel, M; Saklani, A; Shrikhande, SV.
    Background: Frozen Sections (FS) are used to assess margins, for staging, and primary diagnosis. FS guide intraoperative treatment decisions in oncological gastro-intestinal tract surgeries and further management of the patients. Aim: To analyze the distribution, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of frozen sections in gastrointestinal pathology in our institution during the period of 3 years (2016–2018). Material and Methods: This study was an audit to determine the accuracy of FS reports by comparing them with the paraffin section (PS) reports. The FS diagnoses and their PS diagnoses were noted in 1704 gastrointestinal surgeries during the period from 2016 to 2018. Discrepancies were noted and slides of discrepant cases were reviewed to determine the cause. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated using the standard formulae. Results: Out of 1704 cases, correct diagnosis on frozen section was made in 1649 cases (96.77%), 20 (1.17%) were deferred cases, and 35 (2.05%) were discrepant cases. The commonest discrepancies were seen in the primary diagnosis of the gall bladder and gastrectomy margins. The commonest causes for discrepancies were interpretation errors and technical errors. Sensitivity was 91.71%, specificity was 99.69%, positive predictive value was 98.84%, negative predictive value was 97.68%, and accuracy was 97.92%. Conclusion: FS diagnosis is a reliable guide to surgeons for intraoperative management. Studying deep cuts and careful sampling at frozen sections will help reduce discrepancies.
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    Study of histopathology reports of loop electrosurgical excision procedure of cervical transformation zone and their correlation with preprocedural cervical biopsy and/or cytology: An audit
    (Wolters Kluwer - Medknow, 2022-06) Deodhar, KK; Banerjee, D; Rekhi, B; Menon, S; Pathuthara, S.
    Introduction: Loop electrosurgical procedure of the transformation zone of the cervix (LEEP) is the preferred method for many investigators for early detection and treatment of high grade intraepithelial neoplasia(HGCIN). Histopathology reports of LEEP should contain information about the diagnosis, presence or absence of neoplasia ( with its grade) and comment on excison margins. Aim: Our aim was to study LEEP reports for its contents and to see their correlation with preprocudure histology and/or cytology report. Results: Between 2011 and 2017, 44 LEEP reports were archived and studied for their contents from our records. Slides were not reviewed. Mean age was 47.66 years (median 47 years). Forty two (( 95.45%) reports mentioned that all the tissue was examined. Deep cut examination was mentioned in 17/44 cases (38.64%). The concordance rate between LEEP and preprocudure histology and /or cytology for CIN II plus diagnosis is 65.9%. A strict definition is used. If, however, diagnoses between inflammation and CIN I, ASC-H and inflammation, and ASC-H and CIN I are considered non discordant, then the concordance rate rises to 72.7 %. The breakup of discordant cases is given. Conclusion: Literature shows wide range of concordance due to variable definitions and variety of reasons; possible reasons are discussed.