Colorectal Surgical Specimen Lymph Node Harvest: Improvement of Lymph Node Yield with a Pathology Assistant

Reese, Jeffery A.; Hall, Christopher S.; K, Bowles; Moesinger, Robert C.

doi:10.1007/s11605-009-0820-z

Cited by 30 publications

(18 citation statements)

References 17 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study concurs with comparable studies 3 4. Reese et al reported a significant increase in LN harvest when a single PA was made responsible for LN harvest in a single centre 3.…”

Section: Discussionsupporting

confidence: 94%

“…Reese et al reported a significant increase in LN harvest when a single PA was made responsible for LN harvest in a single centre 3. The average numbers of harvested LNs increased, from pathologists averaging 13.6 LNs per specimen to the PA averaging 19.7 LNs.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, starting from 2009, our institution has been training PAs to take over certain routine activities in order to save pathologists’ valuable time, which they can use instead to focus on microscopy and on interdisciplinary meetings. Based on our own experience and on results of other studies, we expect that adequately trained PAs can contribute to patient safety 3 4…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Better retrieval of lymph nodes in colorectal resection specimens by pathologists’ assistants

Kuijpers¹,

Slooten²,

Schreurs

et al. 2012

J Clin Pathol

View full text Add to dashboard Cite

PAs sampled ≥10 LNs in significantly more cases than pathologists did (83.2% vs 60.9% in hospital A and 79.2% vs 67.6% in hospital B) and recovered on average significantly more LNs than pathologists did (18.5 vs 12.2 in hospital A and 16.6 vs 13.2 in hospital B). PAs harvested a significantly higher percentage of LNs <5 mm than pathologists did (64.2% vs 53.7%). The percentages of colon cancer patients eligible for adjuvant chemotherapy due to inadequate LN sampling alone were significantly higher for cases dissected by pathologists than for those dissected by PAs (17.3% vs 1.1% in hospital A and 13.1% vs 3.4% in hospital B) CONCLUSIONS: PAs contribute to patient safety since they recover more and, in particular, smaller LNs from colorectal resection specimens than pathologists do. Moreover, they help to reduce costs and morbidity by reducing the number of patients eligible for adjuvant chemotherapy due to inadequate LN sampling alone.

show abstract

“…This study concurs with comparable studies 3 4. Reese et al reported a significant increase in LN harvest when a single PA was made responsible for LN harvest in a single centre 3.…”

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Better retrieval of lymph nodes in colorectal resection specimens by pathologists’ assistants

Kuijpers¹,

Slooten²,

Schreurs

et al. 2012

J Clin Pathol

View full text Add to dashboard Cite

show abstract

“…At the same time, the use of a template in reporting has reduced the amount of time the pathologist spends on reporting. Also, technician or pathologist assistants have been demonstrated to achieve higher yield rates for lymph nodes in several studies, probably related to more time taken and a higher dedication to the work [32,60,61,62,63]. …”

Section: Resultsmentioning

confidence: 99%

Qualitative and Quantitative Issues of Lymph Nodes as Prognostic Factor in Colon Cancer

Veen¹,

Nedrebø²,

Stormark³

et al. 2013

Dig Surg

View full text Add to dashboard Cite

For patients undergoing curative resections for colon cancer, the nodal status represents the strongest prognostic factor, yet at the same time the most disputed issue as well. Consequently, the qualitative and quantitative aspects of lymph node evaluation are thus being scrutinized beyond the blunt distinction between ‘node positive' (pN+) and ‘node negative' (pN0) disease. Controversy ranges from a minimal or ‘least-unit' strategy as exemplified by the ‘sentinel node' to a maximally invasive or ‘all inclusive' approach by extensive surgery. Ranging between these two extremes of node sampling strategies are factors of quantitative and qualitative value, which may be subject to modification. Qualitative issues may include aspects of lymph node harvest reflected by surgeon, pathologist and even hospital performance, which all may be subject to modification. However, patient's age, gender and genotype may be non-modifiable, yet influence node sample. Quantitative issues may reflect the balance between absolute numbers and models investigating the relationships of positive to negative nodes (lymph node ratio; log odds of positive lymph nodes). This review provides an updated overview of the current controversies and a state-of-the-art perspective on the qualitative and quantitative aspects of using lymph nodes as a prognostic marker in colon cancer.

show abstract

“…The work expected from a resident in a department should be handled by new posts such as "macroscopy technicians". Specially trained macroscopy technicians have been used widely for more than 50 years especially in the U.S.A. and U.K. to process selected biopsies under inspection and are said to provide enormous benefit (16,(18)(19)(20)(21). The excessive workload of residents especially at training hospitals in Turkey (1,17) can be decreased with macroscopy technicians, as can be seen in other countries, and the training improved (22).…”

Section: Discussionmentioning

confidence: 99%

Pathology laboratories staff workload evaluation in turkey: a survey study

Usubütün

Üner²,

Harorlu³

et al. 2011

TJPATH

View full text Add to dashboard Cite

Objective: The workload affects the quality of the pathology report. The aim of this study was to investigate the territorial distribution and productivity of pathology laboratories around Turkey and to estimate the staff workload. Material and Method:A survey questioning the workload was sent to all Ministry of Health and university hospitals. Staff workload was questioned according to the hospital classification and educational activity to evaluate the productivity. Data were entered using SPSS 16.0 statistical software package program and the distribution criteria, t-test and one-way anova were used in the analysis to evaluate the differences between the averages.Results: An average of 2.8 pathologists worked at the pathology laboratories. A total of 5.500 biopsies and 3.750 cytology specimens were received and 20.000 blocks prepared per year. Pathologists evaluated 1.935 biopsies and 1.400 cytology specimens on average and this is equivalent to 2.718 biopsies per year. Gynecology and general surgery department materials constituted 57 percent of all biopsies. Each technician prepared 6.200 blocks, 11.500 slides and 1.000 immunohistochemistry preparations on average. An average of 3.4 paraffin blocks was prepared for each biopsy. The efficiency was low in 17% of teaching hospitals and 77.8% of non-teaching hospitals. In contrast 62.5% of teaching hospitals had work overload. The majority (70.5%) of the respondents mentioned staff shortage. Conclusion:There is no pathologist shortage in Turkey and the problem is workload distribution. Pathology residents' overwork would be reduced by using pathology assistants. There is no shortage of technicians or secretaries, but uneven distribution. Pathology staff planning must be tailored taking into account the features of each hospital. Standard planning for all hospitals is not suitable.Key Words: Pathology, Laboratories, Staff workload, Quality control ÖZ Amaç: Çalışanları iş yükü, patoloji raporunun kalitesini etkiler. Bu çalışmanın amacı, Türkiye' de kamu hastanelerinde patoloji laboratuvarlarının ülke genelindeki dağılımlarını, verimliliklerini ve laboratuvarlarda çalışan personelin iş yüklerini ortaya koymaktır. Gereç ve Yöntem:Sağlık Bakanlığı ve üniversitelere bağlı tüm patoloji laboratuvarlarına iş yüklerini sorgulayan bir anket formu posta yolu ile gönderilmiştir. Personel iş yükleri, hastane sınıfları, asistan eğitimi olan ve olmayan kurumlara göre değerlendirilmiş, verimsiz laboratuvarlar saptanmaya çalışılmıştır. Veriler SPSS 16.0 istatistik paket programı aracılığıyla girilmiş ve analizlerde dağılım ölçütleri ve ortalamalar arası farkı değerlendirmek için t-testi ve tek yönlü varyans analizi kullanılmıştır. Bulgular: Laboratuvarlarda ortalama 2.8 patolog çalışmakta, ortalama 5.500 biyopsi, 3.750 sitolojik örnek gelmekte, 20.000 blok yapılmaktadır. Patolog başına yılda ortalama 1.935 biyopsi, 1.400 sitoloji ve toplamda 2.718 biyopsi eşdeğeri iş düşmektedir. Tüm biyopsilerin %57'sini jinekoloji ve genel cerrahi bölümleri göndermektedir. Bir teknisye...

show abstract

Colorectal Surgical Specimen Lymph Node Harvest: Improvement of Lymph Node Yield with a Pathology Assistant

Abstract: Over time, lymph node harvests at our hospital dramatically improved. The training of a pathology assistant to harvest the lymph nodes from colorectal cancer specimens dramatically affected lymph node harvests and can be a crucial component of pathologic analysis of these specimens.

Cited by 30 publications

References 17 publications

Better retrieval of lymph nodes in colorectal resection specimens by pathologists’ assistants

Better retrieval of lymph nodes in colorectal resection specimens by pathologists’ assistants

Qualitative and Quantitative Issues of Lymph Nodes as Prognostic Factor in Colon Cancer

Pathology laboratories staff workload evaluation in turkey: a survey study

Contact Info

Product

Resources

About