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Henry K Watter
Hervey Bay Hospital, Australia
Posters & Accepted Abstracts: Surg Case Rep
CRoutine histology for haemorrhoidectomy specimens remains commonplace in clinical practice, as a method of detecting incidental anal cancer. However, its utility and cost-effectiveness is unclear. This study aimed to determine the cost-effectiveness of routine histology for haemorrhoidectomy specimens in a regional Australian hospital and to determine the proportion of specimens sent for histology, and whether individual surgeons had a statistically significant preference for whether to send for histology. This was a retrospective cohort study of patients who received haemorrhoidectomies at Hervey Bay Hospital between March 2012 and May 2020. Cost effectiveness of routine histology was investigated by weighing the number of incidental anal cancers detected against the cost of analysis. The proportion sent for histology was determined, both as a whole and by individual consultant surgeons. Routine histology was ordered in 65% of patients who received haemorrhoidectomies over the study period (n=119), costing $13,623 AUD ($1,651 AUD per year). No cases of incidental anal dysplasia or neoplasia were found. Only 1 of the 8 most prolific surgeons over the study period demonstrated a statistically significant preference for whether to send for histology. Our study does not support routine histology for haemorrhoidectomy specimens as a cost-effective practice for detecting incidental anal cancer. Most individual surgeons did not display a clear preference for whether to send for histology. References: 1. Henry K Watter, et al, (2005). Is routine pathologic evaluation of hemorrhoidectomy specimens necessary? Gastroenterol Clin Biol. 2005;29(2):659-61 2. Henry K Watter, et al, (2015).Unexpected anal squamous cells carcinoma after open hemorrhoidectomy. Case Rep Surg. 2015;2015:616274. 3. Henry K Watter, et al, (2015).. Treatment of hemorrhoids: a coloproctologist’s view. World J Gastroenterol. 2015;21(31):9245- 52. 4. Henry K Watter, et al, (2020). Routine pathology examination in the era of value-based healthcare: the case of haemorrhoids specimens. Updates Surg. 2020;72:83-8. 5. Henry K Watter, et al, (2012).. Anal cancer- a review. Int J Health Sci (Qassim). 2012;6(2):206-30
Henry Watter is a working in the Hervey Bay Hospital of Australia. He has completed his Master's degree at the University of Queensland, Australia. He has participated in various conferences and conventions.
