Our Summary

The research paper is about a study that looked at whether it’s necessary to always do a detailed tissue examination (known as a histopathological examination) for patients who are going through a specific type of bowel surgery (sigmoidectomy) for a condition called diverticular disease. The researchers looked back at medical records of patients who had this surgery after having a colonoscopy (a test that allows doctors to look at the inner lining of your large intestine) a year before the surgery.

They found that in most cases (around 96%), the colonoscopy results from a year before the surgery accurately predicted what the tissue examination after surgery would show. This means that only a few patients (around 4%) had unexpected results in the tissue examination. Of these, only one patient (0.5%) had a result that was clinically significant (a type of lymphoma, or cancer).

So, the researchers concluded that it may not be necessary to do a routine tissue examination for all patients having this type of bowel surgery. This could potentially save time and resources. However, the decision would have to be made on a case-by-case basis, considering the patient’s medical history and risk factors.

FAQs

  1. What is the purpose of the histopathological examination in sigmoidectomy procedures?
  2. What did the researchers find about the accuracy of colonoscopy results compared to the tissue examination results after surgery?
  3. Based on the study, is it always necessary to conduct a tissue examination after a sigmoidectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is that in most cases, a detailed tissue examination may not be necessary if the colonoscopy results from before the surgery accurately predict what the tissue examination after surgery will show. However, decisions about whether to perform a tissue examination should be made on a case-by-case basis, taking into account the patient’s medical history and risk factors.

Suitable For

Patients who are typically recommended sigmoidectomy are those with severe or recurrent diverticular disease, which is a condition where small pouches (diverticula) form in the walls of the colon and become inflamed or infected. Sigmoidectomy is a surgical procedure to remove part of the sigmoid colon, which is the lower part of the large intestine where diverticula are most common.

Patients who have complications of diverticular disease such as perforation, abscess, fistula, or severe bleeding may also be recommended sigmoidectomy. Additionally, patients who have not responded to conservative treatments such as dietary changes, medications, or endoscopic procedures may require surgery.

It is important for patients to discuss their individual situation with their healthcare provider to determine if sigmoidectomy is the appropriate treatment option for them.

Timeline

Before sigmoidectomy:

  • Patient experiences symptoms of diverticular disease, such as abdominal pain, bloating, and changes in bowel habits.
  • Patient undergoes a colonoscopy to diagnose the condition and determine the need for surgery.
  • If surgery is recommended, patient undergoes pre-operative preparations, such as fasting and bowel preparation.

After sigmoidectomy:

  • Patient undergoes the sigmoidectomy surgery to remove the affected part of the colon.
  • After surgery, patient may experience pain, bloating, and fatigue as they recover.
  • Tissue from the surgery is sent for histopathological examination to determine if there are any unexpected findings, such as cancer.
  • Patient follows post-operative care instructions, such as taking medications, eating a special diet, and gradually increasing physical activity.
  • Patient attends follow-up appointments to monitor their recovery and address any concerns.

Overall, the patient goes through a process of diagnosis, surgery, and recovery, with the goal of alleviating symptoms and improving their quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sigmoidectomy in light of this study include:

  1. Is a histopathological examination routinely performed after sigmoidectomy for diverticular disease, and is it necessary for my case?
  2. What are the potential risks and benefits of not performing a detailed tissue examination after surgery?
  3. Based on my medical history and risk factors, do you recommend a routine tissue examination for me?
  4. What factors would you consider in deciding whether or not to perform a histopathological examination in my case?
  5. If unexpected results are found in the tissue examination after surgery, what are the potential implications and next steps?
  6. Are there any alternative methods or tests that could be used to assess the need for a detailed tissue examination after sigmoidectomy?
  7. How will the decision regarding a tissue examination be communicated and discussed with me before and after surgery?
  8. Are there any specific follow-up or monitoring measures that should be taken if a detailed tissue examination is not performed after sigmoidectomy?

Reference

Authors: Petrusic A, Mongelli F, Sabbatini F, Christoforidis D, Pini R, Merlo E, Popeskou SG, La Regina D, Iaquinandi F. Journal: Colorectal Dis. 2024 Nov 6. doi: 10.1111/codi.17220. Online ahead of print. PMID: 39505824