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Techniques in Coloproctology

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Open Access 01-04-2021 | Anal Cancer | Original Article

High-resolution anoscopy, is there a benefit in proceeding directly to the operating room?

Authors: B. Moeckli, J. Canner, A. Najafian, S. Carbunaru, N. Cowell, C. Atallah, E. Paredes, A. Chudnovets, S. H. Fang

Published in: Techniques in Coloproctology | Issue 4/2021

Abstract

Background

The development of high-resolution anoscopy (HRA) has advanced our ability to detect anal dysplasia. Historically, HRA is performed in a clinical setting and subsequent ablation is performed in the clinical setting or operating room. The aim of this study was to determine the most effective venue for the performance of HRA.

Methods

Following institutional review board (IRB) approval, the correlation between anal cytology and HRA performed in the clinic versus in the operating room was evaluated. Data were extracted from our IRB-approved prospective HRA database over the time period of 2013–2017.

Results

One hundred twenty-eight HRAs were compared (101 in the clinical setting, 27 in the operating room). There was a statistically significant difference in the correlation between anal cytology and HRA pathology for procedures performed in the clinical setting (55% [56/101]) versus those performed in the operating room (82% [22/27]) (p = 0.014). More biopsies were obtained in the operating room than in the clinic setting (3 vs. 1, p < 0.0001). The majority of patients who had HRA in a clinical setting with subsequent HRA in the operating room stated that they preferred to have their HRAs performed in the operating room due to discomfort from the HRA procedure.

Conclusions

Detection rates for anal dysplasia on HRA, are significantly higher when performed in the operating room. To prevent discomfort in the clinical setting, patients with high-grade dysplasia on anal pap testing may benefit from proceeding directly to the operating room for concurrent HRA and ablation.

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Title: High-resolution anoscopy, is there a benefit in proceeding directly to the operating room?
Authors: B. Moeckli
J. Canner
A. Najafian
S. Carbunaru
N. Cowell
C. Atallah
E. Paredes
A. Chudnovets
S. H. Fang
Publication date: 01-04-2021
Publisher: Springer International Publishing
Keywords: Anal Cancer
Anal Cancer
Published in: Techniques in Coloproctology / Issue 4/2021
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-021-02416-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

High-resolution anoscopy, is there a benefit in proceeding directly to the operating room?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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