Intraoperative consultation
Revision as of 21:07, 2 March 2012 by Michael (talk | contribs) (→Why ICs are done: +frozen section & permanents)
Intraoperative consultation, also quick section and frozen section, is when a surgeon requests an opinion during an operation so that they can appropriately manage a patient. It is abbreviated IC.
Why ICs are done
Reasons why IC are done:[1]
- Determine diagnosis & appropriate extent of operation ~ 50%.
- Margins status - 15%.
- Triage tissue ~ 10%.
- Inform family ~ 8%.
- Sufficient tissue? ~ 8%.
Frozen section correlation with permanents
Main article: Quality
Categories by ADASP:
- Agreement
- Deferral - appropriate.
- Deferral – inappropriate
- Recommendation <=10% threshold.
- Disagreement – Minor.
- Disagreement – Major.
- Recommendation <=3% threshold.
Common specimens
Gynecologic:
- Pelvic mass - diagnosis.
- Ovarian mass - diagnosis.
- Uterine mass - diagnosis.
- Sentinel lymph node - staging.
- Vulvar melanoma.
Head and neck:
- Squamous cell carcinoma - margins.
Gastrointestinal tract:
- Whipple procedure - margins.
- Liver resection - margins.
- Lower anterior resection - distal margin.
Genitourinary tract:
- Cystectomy - ureteral margins.
Pulmonary:
- Pneumonectomy:
- Bronchus - margins.
- Lymph nodes - staging.
Neurologic:
- Brain tumour - diagnosis.
- Spinal tumour - diagnosis.
Thyroid gland:
- Thyroid nodule - diagnosis.
Prosthetic joint:
- Query prosthetic joint infection.
See also
References
- ↑ Zarbo, RJ.; Schmidt, WA.; Bachner, P.; Howanitz, PJ.; Meier, FA.; Schifman, RB.; Boone, DJ.; Herron, RM. (Jan 1996). "Indications and immediate patient outcomes of pathology intraoperative consultations. College of American Pathologists/Centers for Disease Control and Prevention Outcomes Working Group Study.". Arch Pathol Lab Med 120 (1): 19-25. PMID 8554440.