PubMed · 4929185
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P Haour. 1971. [The urocytogram].. https://pubmed.ncbi.nlm.nih.gov/4929185/
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BACKGROUND: The presence of tumor cells in peritoneal washing cytology specimens taken during surgery affects the staging of many gynecologic malignancies. Peritoneal washings are often collected routinely, even in cases of presumed benign disease. This study was designed to address whether evaluation of these specimens is justified. METHODS: We reviewed diagnostic reports from all peritoneal washings and the corresponding surgical pathology specimens from patients undergoing gynecologic surgery during a 1-year period in one institution and a 20-month period in the other. Cases were divided into benign and malignant categories based on the surgical pathology diagnosis. RESULTS: Three hundred forty-six patients had peritoneal washings collected during the study period. The proportion of cases with malignancy was 30% in one institution and 49% in the other. Of these, 119 had an endometrial or ovarian malignancy, including 16 ovarian tumors of low malignant potential. Malignant cells were detected in 19 cases. In 10 of these 19, grossly apparent peritoneal tumor implants were present at the time of surgery. The remaining 227 were found to have benign disease, and the peritoneal washing cytology diagnosis was negative in all cases. Potential savings of $13,000 to $17,000 based on current insurance reimbursement could have been realized for these 227 patients without compromising patient care. CONCLUSIONS: These data suggest that peritoneal washing cytology specimens collected at the time of gynecologic surgery for presumed benign disease can be held and processed later if an unsuspected malignancy is discovered. This practice can result in cost savings without compromising patient care. Cancer (Cancer Cytopathol)
Pap smears obtained with Ayre spatula and cytobrush by four experienced private practice gynecologists were submitted to the cytology laboratory on either two slides or one slide. For each physician, 500 consecutive cases were studied for each of 4 consecutive years. Compared to the first 2 years (double-slide cases), the rates of abnormal smears increased from 4.28 to 5.58% while the number of unsatisfactory smears decreased from 1.83 to 0.98% for the years with all single-slide cases. These changes were not statistically significant. Follow-up biopsy findings were not different between the groups. Similar findings were seen when the medical community that submits smears to this laboratory began to use primarily a single-slide technique. The daily screening workload in the laboratory decreased 29% as mostly one-slide smears were submitted despite an increase of 10% in the number of cases. The double-slide method for Pap smears can be safely replaced by a single-slide method.
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