Intraoperative consultation in digestive surgery. A consecutive series of 800 frozen sections

Aim: To assess indications and quality of frozen sections in digestive surgery. Patients and methods: All the frozen sections from the department of digestive surgery from Amiens hospital performed between 01/07/2006 and 01/07/2010 were assessed. Assessment of frozen section forms, reading of pathology reports, and reviewing of frozen section slides were performed. Results: Eight hundred frozen sections were performed in 349 patients. From one to 14 surgical specimens were sent for frozen section (mean 2.3). Frozen sections were performed in 77% of the cases for cancer surgery (n = 268), most of the time pancreatic surgery (28.4%) and liver surgery (24.6%). Frozen sections were performed in 69% of the cases for diagnosis, in 29% of the cases to assess surgical margins and in 2% of the cases to assess if tissue specimen was appropriate for pathological diagnosis. Frozen sections were sent all days of the week (except Saturday and Sunday), during all the year, between 8 H 30 and 17 H 15. Thirty-seven percent of the cases were sent between 12 H and 14 H. Response time was 15 minutes (3 to 57 minutes). Rate of differed diagnoses was 2%. Rate of discordant diagnoses was 3.4%. Conclusion: Frozen section is a rapid and accurate tool in digestive surgery. Local adjustment of the organization of the Pathology Department could enhance the rapidity and the quality of pathology diagnoses. (C) 2012 Elsevier Masson SAS. All rights reserved.