Doughnuts
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.