What is a frozen section examination?

A frozen section examination is a specific type of biopsy procedure that allows a surgeon to establish a rapid diagnosis of a suspicious mass during surgery. The technical name for this procedure is cryosection.

A frozen section is conducted during surgery on patients with ovarian and pelvic masses while patients are under anaesthetic. While patients are asleep, the surgeon removes tissue from a suspicious mass from an ovary or a uterus, and sends it to a pathologist who is present in the operating theatre. The pathologist freezes the tissue with liquid nitrogen, cuts it, and then stains it with special staining solutions so that it can be viewed under a microscope.

The diagnosis from the frozen section is provided back to the surgeon while the patient is still under general anaesthesia. While this procedure prolongs the surgery, it will provide your surgeon with a preliminary diagnosis of whether a suspicious mass is benign or contains cancer. If benign, the surgery can be more limited or conservative. If the tissue is cancerous then more tissues should be removed (e.g., omentum, lymph nodes) to determine the extent of the cancer, which generates important information for the selection of further postoperative treatment.

Pathology SlideTime is important in performing a frozen section to reduce the amount of time that the patient is under general anaesthetic. A frozen section usually takes between 30 and 45 minutes.

Sometimes the frozen section approach is non-diagnostic or inconclusive because only a limited number of sections can be taken and examined by the pathologist in the short time available.

Following the surgery, all tissues that have been removed during surgery will be examined under the microscope, which is the most accurate method. However this takes 1 to 2 days, and therefore the surgeon does not receive the result during surgery. Tissues are placed in a fixative solution, embedded in wax, thinly cut, and then stained to be viewed under a microscope.

Research has found a frozen section is an accurate and useful method compared to a permanent section (final histopathological diagnosis).

In a study of 60 cases of ovarian tumours the overall accuracy of frozen section diagnosis was found to be 93.3% in comparison with final histopathological diagnosis.

Overall, the results from a frozen section can help to decide the most appropriate type and extent of surgery.

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