Difference between revisions of "Doughnuts"
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[[Image:Rosquillas.JPG|thumb|right|They have the same shape as these.]] | |||
'''Doughnuts''', also '''donuts''', in [[pathology]] refer to the ring-shaped piece of [[colon|large bowel]] from a circular end-to-end stapling device.<ref name=pmid22091338>{{Cite journal | last1 = Zachariah | first1 = SK. | title = Reverse Transrectal Stapling Technique Using the EEA Stapler: An Alternative Approach in Difficult Reversal of Hartmann's Procedure. | journal = J Surg Tech Case Rep | volume = 2 | issue = 2 | pages = 70-2 | month = Jul | year = 2010 | doi = 10.4103/2006-8808.73618 | PMID = 22091338 }}</ref> | '''Doughnuts''', also '''donuts''', in [[pathology]] refer to the ring-shaped piece of [[colon|large bowel]] from a circular end-to-end stapling device.<ref name=pmid22091338>{{Cite journal | last1 = Zachariah | first1 = SK. | title = Reverse Transrectal Stapling Technique Using the EEA Stapler: An Alternative Approach in Difficult Reversal of Hartmann's Procedure. | journal = J Surg Tech Case Rep | volume = 2 | issue = 2 | pages = 70-2 | month = Jul | year = 2010 | doi = 10.4103/2006-8808.73618 | PMID = 22091338 }}</ref> | ||
These are also known an '''EEA donuts''' and '''CEEA donuts'''.<ref name=pmid22091338/> | These are also known an '''EEA donuts''' and '''CEEA donuts'''.<ref name=pmid22091338/> | ||
''CEEA'' is '' | ''CEEA'' is ''circular end-to-end anastomosis''. ''EEA'' is trademarked. Presumably, it is an abbreviation for ''end-to-end anastomosis''. | ||
CEEA staplers are particularly useful in low lying tumours; they allow more individuals to safely have a [[lower anterior resection]] instead of the less desirable [[abdominoperineal resection]] (APR).<ref name=pmid3728802>{{Cite journal | last1 = Trollope | first1 = ML. | last2 = Cohen | first2 = RG. | last3 = Lee | first3 = RH. | last4 = Cannon | first4 = WB. | last5 = Marzoni | first5 = FA. | last6 = Cressman | first6 = RD. | title = A 7 year experience with low anterior sigmoid resections using the EEA stapler. | journal = Am J Surg | volume = 152 | issue = 1 | pages = 11-5 | month = Jul | year = 1986 | doi = | PMID = 3728802 }}</ref> | |||
==Pathology in donuts== | |||
The value of assessing donuts in the context of ''lower anterior resections'' is questioned. A study of 125 individuals by Speake and Abercrombie found the pathologic assessment of donuts added nothing significant.<ref name=pmid12585627>{{Cite journal | last1 = Speake | first1 = WJ. | last2 = Abercrombie | first2 = JF. | title = Should 'doughnut' histology be routinely performed following anterior resection for rectal cancer? | journal = Ann R Coll Surg Engl | volume = 85 | issue = 1 | pages = 26-7 | month = Jan | year = 2003 | doi = | PMID = 12585627 }}</ref> A larger study of 336 individuals by Ng ''et al.'' reached the same conclusion and noted that the cost of processing all those donuts by pathology costed over $60,000 (US dollars).<ref name=pmid24798632>{{Cite journal | last1 = Ng | first1 = CW. | last2 = Lieske | first2 = B. | last3 = Tan | first3 = KK. | title = Routine histological sampling of doughnuts post oncologic anterior resection is not necessary. | journal = Int J Colorectal Dis | volume = 29 | issue = 7 | pages = 843-5 | month = Jul | year = 2014 | doi = 10.1007/s00384-014-1886-y | PMID = 24798632 }}</ref> | |||
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===Normal=== | |||
<pre> | |||
A. Proximal Donut, Excision: | |||
- Colorectal wall within normal limits. | |||
- NEGATIVE for malignancy. | |||
B. Distal Donut, Excision: | |||
- Colorectal wall within normal limits. | |||
- NEGATIVE for malignancy. | |||
</pre> | |||
==See also== | ==See also== | ||
*[[Colon]]. | *[[Colon]]. | ||
*[[Rectum]]. | *[[Rectum]]. | ||
*[[Donut cell]]. | |||
*[[Abdominoperineal resection grossing]]. | |||
*[[Pathology and food]]. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
==External links== | |||
*[http://www.atlasofpelvicsurgery.com/7Colon/6LowAnastomosisofColontoRectumUsingtheEnd-to-EndSurgicalStaplerTechnique/chap7sec6.html The creation an EEA donut - drawings (atlasofpelvicsurgery.com)]. | |||
[[Category:Clinical]] | [[Category:Clinical]] | ||
Latest revision as of 21:30, 25 September 2023
Doughnuts, also donuts, in pathology refer to the ring-shaped piece of large bowel from a circular end-to-end stapling device.[1]
These are also known an EEA donuts and CEEA donuts.[1] CEEA is circular end-to-end anastomosis. EEA is trademarked. Presumably, it is an abbreviation for end-to-end anastomosis.
CEEA staplers are particularly useful in low lying tumours; they allow more individuals to safely have a lower anterior resection instead of the less desirable abdominoperineal resection (APR).[2]
Pathology in donuts
The value of assessing donuts in the context of lower anterior resections is questioned. A study of 125 individuals by Speake and Abercrombie found the pathologic assessment of donuts added nothing significant.[3] A larger study of 336 individuals by Ng et al. reached the same conclusion and noted that the cost of processing all those donuts by pathology costed over $60,000 (US dollars).[4]
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Normal
A. Proximal Donut, Excision: - Colorectal wall within normal limits. - NEGATIVE for malignancy. B. Distal Donut, Excision: - Colorectal wall within normal limits. - NEGATIVE for malignancy.
See also
References
- ↑ 1.0 1.1 Zachariah, SK. (Jul 2010). "Reverse Transrectal Stapling Technique Using the EEA Stapler: An Alternative Approach in Difficult Reversal of Hartmann's Procedure.". J Surg Tech Case Rep 2 (2): 70-2. doi:10.4103/2006-8808.73618. PMID 22091338.
- ↑ Trollope, ML.; Cohen, RG.; Lee, RH.; Cannon, WB.; Marzoni, FA.; Cressman, RD. (Jul 1986). "A 7 year experience with low anterior sigmoid resections using the EEA stapler.". Am J Surg 152 (1): 11-5. PMID 3728802.
- ↑ Speake, WJ.; Abercrombie, JF. (Jan 2003). "Should 'doughnut' histology be routinely performed following anterior resection for rectal cancer?". Ann R Coll Surg Engl 85 (1): 26-7. PMID 12585627.
- ↑ Ng, CW.; Lieske, B.; Tan, KK. (Jul 2014). "Routine histological sampling of doughnuts post oncologic anterior resection is not necessary.". Int J Colorectal Dis 29 (7): 843-5. doi:10.1007/s00384-014-1886-y. PMID 24798632.