Aims Accurate histopathological evaluation of the endoscopic submucosal dissection (ESD) specimens is essential for clinicians to guide further triage and management. This study aimed to report a novel processing technique for large ESD (≥4 cm) specimens.
Methods 92 patients with colorectal neoplasms who had undergone ESD were included. 46 ESD specimens were treated with conventional handling process, while the rest 46 cases were given the optimised method. Macrobiocassettes and L-shaped embedding moulds were applied in the optimised method. We evaluated the efficacy of this improved procedure in terms of the number of paraffin blocks, storage space and time consumption of pathological assessment.
Results The average diameter of ESD specimens was 4.5±0.4 cm and 4.7±0.5 cm in the control and test group (p=0.023), respectively. In control group, 398 paraffin blocks of 46 cases were obtained. With the same cases number and larger lesion size, only 276 blocks were achieved in test group (p<0.001). As for the storage space, the total volume of paraffin blocks and slides (4554.0 cm3 and 1207.5 cm3) of optimised method was significantly reduced compared with the control group (6208.8 cm3 and 1741.3 cm3) (p=0.001, p<0.001). In addition, the optimised method was superior to the conventional one in shortening time consumption of pathological assessment (164.5 min and 269.0 min, p<0.001).
Conclusions The optimised technique not only reduced the workload and storage space, but also facilitated accurate pathological assessment.
- colorectal neoplasms
- pathology, surgical
Data availability statement
Data are available on reasonable request.
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Handling editor Runjan Chetty.
ZY and DJ contributed equally.
Contributors Study conception design: YH and CX; Data acquisition: ZY, DJ and RL; Data analysis and interpretation: ZY, WH, HW, JS and JL; Writing-original draft preparation: ZY, DJ, WH and HW; Writing-review and editing: YH, CX, RL, JS and JL. YH is responsible for the overall content as the guarantor. All authors read and approved the final manuscript.
Funding This work was supported by the Quality control and management system for whole procedure of precision medicine (2017YFC0910003). Shanghai Municipal Commission of Science and Technology (No. 19441904000), Shanghai Municipal Key Clinical Specialty (No. shslczdzk01302) and Shanghai Science and Technology Development Fund (No. 19MC1911000).
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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