Scholarlink

Background <p>In the present era of cost containment an analysis of various clinical investigations including histopathological analysis becomes important with the to improve health care system by proper utilization of financial resources especially in minimal invasive procedures where cost of instrumentation is high. Pyeloplasty remains one of the most performed procedure in pathology in both pediatric and adult urology with pathological assessment of resected PUJ being routine practice. We hypothesized that routine histopathological examination in patients undergoing pyeloplasty does not provide any significant new diagnosis which can affect further patient management.</p> Methods <p>Medical records of 142 renal units undergoing Anderson–Hynes dismembered pyeloplasty were reviewed. Operative findings, pathological reports, and postoperative outcomes were analyzed to determine the diagnostic utility of HPE. Cost data were retrieved from institutional billing and pathology records. The cumulative carbon footprint and manhours saved from omitting routine HPE were estimated.</p> Results <p>Histopathology demonstrated chronic inflammation with fibrosis in 94 (66%), smooth muscle hypertrophy in 25 (18%), increased elastin in 13 (9%) and smooth muscle atrophy in 10 (7%) cases. No pathological diagnosis altered postoperative management. Redo pyeloplasty was required in 4 cases, all attributable to anatomical or technical factors, not histological abnormalities. Routine HPE generated a total cost of USD 28,400 Eliminating this practice would save approximately 700–1,000 pathology man hours and reduce 50–120&#xa0;kg of CO₂ emissions annually in comparable surgical volumes.</p> Conclusion <p>The routine HPE in pediatric pyeloplasty yields no clinical benefit, adds unnecessary cost, consumes manpower, and contributes to the carbon footprint. A selective HPE strategy appears to be more safe and more sustainable.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Cost and benefit analysis of routine histopathological examination of the pelviureteric junction in pediatric pyeloplasty

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月22日

查看全文
  • Vipul Gupta,
  • Mira Alredha,
  • Dalia Abdulrahman,
  • Ghadir Jaber,
  • Diary Mohammad,
  • Mamoun AlMarzouqi

摘要

Background

In the present era of cost containment an analysis of various clinical investigations including histopathological analysis becomes important with the to improve health care system by proper utilization of financial resources especially in minimal invasive procedures where cost of instrumentation is high. Pyeloplasty remains one of the most performed procedure in pathology in both pediatric and adult urology with pathological assessment of resected PUJ being routine practice. We hypothesized that routine histopathological examination in patients undergoing pyeloplasty does not provide any significant new diagnosis which can affect further patient management.

Methods

Medical records of 142 renal units undergoing Anderson–Hynes dismembered pyeloplasty were reviewed. Operative findings, pathological reports, and postoperative outcomes were analyzed to determine the diagnostic utility of HPE. Cost data were retrieved from institutional billing and pathology records. The cumulative carbon footprint and manhours saved from omitting routine HPE were estimated.

Results

Histopathology demonstrated chronic inflammation with fibrosis in 94 (66%), smooth muscle hypertrophy in 25 (18%), increased elastin in 13 (9%) and smooth muscle atrophy in 10 (7%) cases. No pathological diagnosis altered postoperative management. Redo pyeloplasty was required in 4 cases, all attributable to anatomical or technical factors, not histological abnormalities. Routine HPE generated a total cost of USD 28,400 Eliminating this practice would save approximately 700–1,000 pathology man hours and reduce 50–120 kg of CO₂ emissions annually in comparable surgical volumes.

Conclusion

The routine HPE in pediatric pyeloplasty yields no clinical benefit, adds unnecessary cost, consumes manpower, and contributes to the carbon footprint. A selective HPE strategy appears to be more safe and more sustainable.