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Intraoperative Cytology for Video-Assisted Thoracic Surgery : A Quality Improvement Analysis

De Las Casas, Luis E. ; Danakas, Alexandra M. ; Torrealba, Jose R. ; Wizorek, Joseph J. ; Ettel, Mark G. ; Lada, Michal J. ; Brunnström, Hans LU orcid ; Plavnicky, John ; Sweeney, Melissa and Jones, Carolyn E. (2022) In Annals of Thoracic Surgery 113(2). p.413-420
Abstract

Background: Frozen section is a standard of care procedure during thoracic surgery when an immediate diagnosis is needed. An alternative procedure is intraoperative cytology. Video-assisted thoracic surgery is currently widely used for thoracic surgical procedures. The aim of this study was to assess intraoperative cytology together with frozen section for accuracy, turnaround time, and total response time during video-assisted thoracic surgery. Methods: We included patients having video-assisted thoracic surgery between August 2018 and February 2019 at our institution. A cytopathologist and a surgical pathologist independently performed intraoperative cytology and frozen sections, respectively. Final histologic diagnosis was the... (More)

Background: Frozen section is a standard of care procedure during thoracic surgery when an immediate diagnosis is needed. An alternative procedure is intraoperative cytology. Video-assisted thoracic surgery is currently widely used for thoracic surgical procedures. The aim of this study was to assess intraoperative cytology together with frozen section for accuracy, turnaround time, and total response time during video-assisted thoracic surgery. Methods: We included patients having video-assisted thoracic surgery between August 2018 and February 2019 at our institution. A cytopathologist and a surgical pathologist independently performed intraoperative cytology and frozen sections, respectively. Final histologic diagnosis was the reference standard. Intraoperative cytology, frozen section turnaround, and total response times were analyzed. Results: A total of 52 specimens from 27 patients were included. The intraoperative cytology correlated with final histology in 98% of cases. Frozen section correlated with final histology in 100% of cases. Intraoperative cytology turnaround and total response times were equal (mean, 4.35 minutes; range, 2-15 minutes). Mean frozen section turnaround and response times were 26.2 minutes (range, 9-61 minutes) and 36.7 minutes (range, 16-90 minutes), respectively. We found a statistically significant difference between intraoperative cytology and frozen section turnaround time and total response times (P < .001). Conclusions: This study highlights that intraoperative cytology could be as accurate as frozen section and considerably faster during video-assisted thoracic surgery (P < .001). Total response time could potentially be used as a quality metric for video-assisted thoracic surgery.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Thoracic Surgery
volume
113
issue
2
pages
413 - 420
publisher
Elsevier
external identifiers
  • scopus:85113285481
  • pmid:33676904
ISSN
0003-4975
DOI
10.1016/j.athoracsur.2021.02.043
language
English
LU publication?
yes
id
2a67cc1e-3564-4947-94fa-94669e9f3e7d
date added to LUP
2021-12-22 11:17:26
date last changed
2024-06-01 22:29:43
@article{2a67cc1e-3564-4947-94fa-94669e9f3e7d,
  abstract     = {{<p>Background: Frozen section is a standard of care procedure during thoracic surgery when an immediate diagnosis is needed. An alternative procedure is intraoperative cytology. Video-assisted thoracic surgery is currently widely used for thoracic surgical procedures. The aim of this study was to assess intraoperative cytology together with frozen section for accuracy, turnaround time, and total response time during video-assisted thoracic surgery. Methods: We included patients having video-assisted thoracic surgery between August 2018 and February 2019 at our institution. A cytopathologist and a surgical pathologist independently performed intraoperative cytology and frozen sections, respectively. Final histologic diagnosis was the reference standard. Intraoperative cytology, frozen section turnaround, and total response times were analyzed. Results: A total of 52 specimens from 27 patients were included. The intraoperative cytology correlated with final histology in 98% of cases. Frozen section correlated with final histology in 100% of cases. Intraoperative cytology turnaround and total response times were equal (mean, 4.35 minutes; range, 2-15 minutes). Mean frozen section turnaround and response times were 26.2 minutes (range, 9-61 minutes) and 36.7 minutes (range, 16-90 minutes), respectively. We found a statistically significant difference between intraoperative cytology and frozen section turnaround time and total response times (P &lt; .001). Conclusions: This study highlights that intraoperative cytology could be as accurate as frozen section and considerably faster during video-assisted thoracic surgery (P &lt; .001). Total response time could potentially be used as a quality metric for video-assisted thoracic surgery.</p>}},
  author       = {{De Las Casas, Luis E. and Danakas, Alexandra M. and Torrealba, Jose R. and Wizorek, Joseph J. and Ettel, Mark G. and Lada, Michal J. and Brunnström, Hans and Plavnicky, John and Sweeney, Melissa and Jones, Carolyn E.}},
  issn         = {{0003-4975}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{413--420}},
  publisher    = {{Elsevier}},
  series       = {{Annals of Thoracic Surgery}},
  title        = {{Intraoperative Cytology for Video-Assisted Thoracic Surgery : A Quality Improvement Analysis}},
  url          = {{http://dx.doi.org/10.1016/j.athoracsur.2021.02.043}},
  doi          = {{10.1016/j.athoracsur.2021.02.043}},
  volume       = {{113}},
  year         = {{2022}},
}