Intraoperative Surgical Pathology Consultation (Frozen Section) in Resource‑Limited Setting

Abstract

Background: Intraoperative consultation aims at guiding decision during surgeries. Frozen section (FS) technique is a valuable tool used to rapidly prepare slides from tissues for microscopic interpretation. Over the past 100 years, FS diagnosis of surgically resected tumors and tissue has become a well‑established practice in developed countries. On the other hand, developing countries only relatively recently got introduced to this technique. However, it remains unpopular due to a number of factors. This study strives to show that an alternative means in terms of reagents can easily be sought when the challenge of resource limitation is encountered. To the best of our knowledge, such a study has not been conducted in Nigeria. Methods: This was a prospective study over 12 weeks in which a comparison was made from surgical biopsy specimens received for intraoperative consultation. Using commercially available cryocompound, optimal cutting temperature (OCT) and readily available, less expensive, easy to handle alternative to embedding media: water and office glue. Staining was by conventional hematoxylin and eosin. Both groups were then viewed with the light microscope and findings were reported and compared. Results: Fifty‑seven cases were studied, of which 24 were positive for tumor. Thirty cases were negative for tumor, and three cases had features consistent with metastatic tumor. Freezing time was 1–2 min for OCT and the glue alternative, while a third group was in frozen water for 2–3 min. The slides’ quality was satisfactory for tissues processed in the OCT and glue; however, those processed in water had the worst outcome in terms of artifacts. Freeze and staining artifact were minimal in tissues processed using OCT and glue, whereas tissues processed using water was worst. Conclusion: Office glue is a readily obtainable alternative medium for FS and can provide satisfactorily comparable results to the conventional OCT in a resource‑limited setting and is in the opinion of the authors, a good alternative.