Avaliação de papel-filtro padronizado para biópsias da superfície ocular
Arquivos
Data
2024-09-27
Autores
Morales, Melina Correia 
Orientadores
Allemann, Norma
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Avaliação do papel-filtro padronizado EyePatho©, com e sem suturas de fixação, para o preparo de espécime de biópsia da superfície ocular. Métodos: Estudo transversal prospectivo, que incluiu 45 olhos de 44 pacientes com indicação de biópsia da superfície ocular. Os grupos foram organizados em três diferentes propostas de preparo de espécimes de superfície ocular (15 olhos por grupo): grupo 1, controle com preparação rotineira usando papel-filtro com suturas de fixação e identificação, grupo 2 usando apenas EyePatho©, e grupo 3 usando EyePatho© com suturas de fixação. Em todos os grupos, se o espécime fosse pequeno a ponto de a realização de uma sutura comprometer a amostra, ele não deveria ser suturado. Os grupos foram comparados considerando o tempo dedicado ao preparo dos espécimes pelo cirurgião, o estado de preservação destes, a praticidade na análise da topografia e da orientação de suas margens pelo patologista e a importância de suturas de fixação do espécime. Resultados: Os grupos foram pareados quanto à localização do tumor, à classificação clínica, ao tipo de biópsia e ao tamanho do espécime (p>0,05 para todas as comparações). O grupo 2 necessitou de menor tempo total para preparação do espécime em comparação com os outros grupos (p<0,05). No entanto, 40% de seus espécimes, todos nodulares, se soltaram do EyePatho© até o momento da análise macroscópica no Departamento de Patologia, evento que não ocorreu nos outros dois grupos, ambos com suturas. O grupo 3 necessitou de menor tempo total em comparação com o grupo-controle (p<0,05) e, para que o patologista compreendesse a topografia e a orientação de margem do espécime, não houve necessidade de informação adicional em nenhum dos casos, enquanto no grupo-controle, esta foi necessária em 100% pela avaliação do desenho esquemático com notas em todos os casos. No grupo 2, o patologista requereu informações adicionais (avaliação de fotografia ou contato com o cirurgião) em 40% dos espécimes, aqueles que haviam se soltado do papel. Conclusão: O uso do papel-filtro padronizado EyePatho© para biópsias da superfície ocular provou-se eficaz em otimizar o tempo dedicado pelo cirurgião no preparo do espécime e em facilitar a compreensão da topografia e da orientação de margens pelo patologista. O uso de suturas para fixação dos espécimes ao papel é recomendado, especialmente em lesões nodulares, para evitar que se soltem até o momento da análise macroscópica.
Purpose: Evaluation of the standardized filter paper EyePatho©, with and without fixation sutures, for handling of ocular surface biopsy specimen. Methods: Cross- sectional prospective study that included 45 eyes from 44 patients with indication of ocular surface biopsy. The groups were organized into three different management proposals for ocular surface specimens (15 eyes per group): group 1, control group with routine preparation using filter paper with sutures for fixation and identification, group 2 using only EyePatho©, and group 3 using EyePatho© with fixation sutures. In all groups, if the specimen was small enough that performing a suture could compromise the sample, it should not be sutured. The groups were compared considering the time dedicated to specimen preparation by the surgeon, the preservation status of these specimens, the practicality in the analysis of topography and orientation of the margins by the pathologist and the importance of specimen fixation sutures. Results: The groups were matched in terms of tumor location, clinical classification, type of biopsy and specimen size (p>0.05 for all comparisons). Group 2 required less total time for specimen preparation compared to the other groups (p<0.05). However, 40% of its specimens, all nodular, detached from the EyePatho© by the time of macroscopic analysis in the Department of Pathology, an event that did not occur in the other groups, both of which had sutures. Group 3 required less total time compared to the control group (p<0.05), and for the pathologist to understand the topography and margin orientation of the specimen, no additional information was needed in any of the cases, whereas in the control group, it was necessary in 100% by evaluation of schematic drawing with notes in all cases. In group 2, the pathologist required additional information (evaluation of photographs or contacting the surgeon) in 40% of the specimens, those that had detached from the paper. Conclusion: The use of standardized filter paper EyePatho© for ocular surface biopsies has proven to optimize time dedicated by the surgeon in specimen preparation and to facilitate the pathologist’s understanding of the topography and margin orientation. The use of sutures to fix the specimens to the paper is recommended, especially for nodular lesions, to prevent them from detaching before macroscopic analysis.
Purpose: Evaluation of the standardized filter paper EyePatho©, with and without fixation sutures, for handling of ocular surface biopsy specimen. Methods: Cross- sectional prospective study that included 45 eyes from 44 patients with indication of ocular surface biopsy. The groups were organized into three different management proposals for ocular surface specimens (15 eyes per group): group 1, control group with routine preparation using filter paper with sutures for fixation and identification, group 2 using only EyePatho©, and group 3 using EyePatho© with fixation sutures. In all groups, if the specimen was small enough that performing a suture could compromise the sample, it should not be sutured. The groups were compared considering the time dedicated to specimen preparation by the surgeon, the preservation status of these specimens, the practicality in the analysis of topography and orientation of the margins by the pathologist and the importance of specimen fixation sutures. Results: The groups were matched in terms of tumor location, clinical classification, type of biopsy and specimen size (p>0.05 for all comparisons). Group 2 required less total time for specimen preparation compared to the other groups (p<0.05). However, 40% of its specimens, all nodular, detached from the EyePatho© by the time of macroscopic analysis in the Department of Pathology, an event that did not occur in the other groups, both of which had sutures. Group 3 required less total time compared to the control group (p<0.05), and for the pathologist to understand the topography and margin orientation of the specimen, no additional information was needed in any of the cases, whereas in the control group, it was necessary in 100% by evaluation of schematic drawing with notes in all cases. In group 2, the pathologist required additional information (evaluation of photographs or contacting the surgeon) in 40% of the specimens, those that had detached from the paper. Conclusion: The use of standardized filter paper EyePatho© for ocular surface biopsies has proven to optimize time dedicated by the surgeon in specimen preparation and to facilitate the pathologist’s understanding of the topography and margin orientation. The use of sutures to fix the specimens to the paper is recommended, especially for nodular lesions, to prevent them from detaching before macroscopic analysis.
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Citação
MORALES, Melina Correia. Avaliação de papel-filtro padronizado para biópsias da superfície ocular. 2024. 70 f. Tese (Doutorado em Oftalmologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2024.