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Article: Multimodality minimally invasive autopsy-A feasible and accurate approach to post-mortem examination

TitleMultimodality minimally invasive autopsy-A feasible and accurate approach to post-mortem examination
Authors
KeywordsMinimally invasive autopsy
Issue Date2010
PublisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/forsciint
Citation
Forensic Science International, 2010, v. 195 n. 1-3, p. 93-98 How to Cite?
AbstractBackground: Autopsy examination has been the bedrock of western medicine. With the decline in the autopsy rate secondary to the negative psychological impact to the deceased's relatives, the benefits of autopsy have been undermined. Minimally invasive autopsy has been introduced but has not been widely adopted as an alternative to the 'traditional' open approach. This technique not only provides information on the cause of death abut also minimizes the disfigurement induced to the deceased. Our study aims to explore the feasibility and evaluate the accuracy of this technique. Methods: A series of coroner cases ordered for autopsy were examined by a group including an experienced forensic pathologist and two experienced laparoscopic surgeons using thoracoscopic, laparoscopic, endoluminal or endovascular approaches. The procedure was video-recorded and the provisional diagnoses and causes of death were made based on the findings. These findings were subsequently correlated with the full autopsy examination. A few limited clinical post-mortem examinations were also performed with consent from relatives. Results: A total of 22 cases of minimally invasive autopsies were performed from November 2007 to March 2008. The median duration of the procedures was 78.3 ± 20.7 min. Thoracoscopies and laparoscopies were performed in 18 patients while additional arterioscopic examination with endoscope was performed in two patients with suspected aortic diseases. Four consented limited clinical autopsies were also performed: two of them involved thoracoscopic biopsies of lung tissues, one was a para-mortem upper endoscopy for the investigation of pathology of the stomach and the other one was laparoscopy for a patient, who died of unexplained acidosis. Comparison with full autopsies showed that the accuracy of the diagnosis was 94.4%, the sensitivity was 90%, the specificity was 100%, the positive predictive value was 100% and the negative predictive value was 88.9%. Conclusion: Minimally invasive autopsy is a feasible approach, yielding accurate findings when compared with conventional autopsies. The former can be a valuable tool for obtaining more valuable information in situations when the next-of-kin of the deceased does not consent to a conventional autopsy. © 2009 Elsevier Ireland Ltd. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/88285
ISSN
2015 Impact Factor: 1.95
2015 SCImago Journal Rankings: 1.210
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFan, JKMen_HK
dc.contributor.authorTong, DKHen_HK
dc.contributor.authorPoon, JTCen_HK
dc.contributor.authorLo, OSHen_HK
dc.contributor.authorBeh, PSLen_HK
dc.contributor.authorPatil, NGen_HK
dc.contributor.authorLaw, WLen_HK
dc.date.accessioned2010-09-06T09:41:22Z-
dc.date.available2010-09-06T09:41:22Z-
dc.date.issued2010en_HK
dc.identifier.citationForensic Science International, 2010, v. 195 n. 1-3, p. 93-98en_HK
dc.identifier.issn0379-0738en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88285-
dc.description.abstractBackground: Autopsy examination has been the bedrock of western medicine. With the decline in the autopsy rate secondary to the negative psychological impact to the deceased's relatives, the benefits of autopsy have been undermined. Minimally invasive autopsy has been introduced but has not been widely adopted as an alternative to the 'traditional' open approach. This technique not only provides information on the cause of death abut also minimizes the disfigurement induced to the deceased. Our study aims to explore the feasibility and evaluate the accuracy of this technique. Methods: A series of coroner cases ordered for autopsy were examined by a group including an experienced forensic pathologist and two experienced laparoscopic surgeons using thoracoscopic, laparoscopic, endoluminal or endovascular approaches. The procedure was video-recorded and the provisional diagnoses and causes of death were made based on the findings. These findings were subsequently correlated with the full autopsy examination. A few limited clinical post-mortem examinations were also performed with consent from relatives. Results: A total of 22 cases of minimally invasive autopsies were performed from November 2007 to March 2008. The median duration of the procedures was 78.3 ± 20.7 min. Thoracoscopies and laparoscopies were performed in 18 patients while additional arterioscopic examination with endoscope was performed in two patients with suspected aortic diseases. Four consented limited clinical autopsies were also performed: two of them involved thoracoscopic biopsies of lung tissues, one was a para-mortem upper endoscopy for the investigation of pathology of the stomach and the other one was laparoscopy for a patient, who died of unexplained acidosis. Comparison with full autopsies showed that the accuracy of the diagnosis was 94.4%, the sensitivity was 90%, the specificity was 100%, the positive predictive value was 100% and the negative predictive value was 88.9%. Conclusion: Minimally invasive autopsy is a feasible approach, yielding accurate findings when compared with conventional autopsies. The former can be a valuable tool for obtaining more valuable information in situations when the next-of-kin of the deceased does not consent to a conventional autopsy. © 2009 Elsevier Ireland Ltd. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/forsciinten_HK
dc.relation.ispartofForensic Science Internationalen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsForensic Science International. Copyright © Elsevier Ireland Ltd.en_HK
dc.subjectMinimally invasive autopsyen_HK
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAutopsy - methods-
dc.subject.meshEndoscopy-
dc.titleMultimodality minimally invasive autopsy-A feasible and accurate approach to post-mortem examinationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0379-0738&volume=195&issue=1-3&spage=93&epage=98&date=2010&atitle=Multimodality+minimally+invasive+autopsy+-+a+feasible+and+accurate+approach+to+post-mortem+examinationen_HK
dc.identifier.emailPoon, JTC: tcjensen@hkucc.hku.hken_HK
dc.identifier.emailBeh, PSL: philipbeh@pathology.hku.hken_HK
dc.identifier.emailPatil, NG: ngpatil@hkucc.hku.hken_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.authorityPoon, JTC=rp01603en_HK
dc.identifier.authorityBeh, PSL=rp00409en_HK
dc.identifier.authorityPatil, NG=rp00388en_HK
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.description.naturepostprint-
dc.identifier.doi10.1016/j.forsciint.2009.11.019en_HK
dc.identifier.pmid20036088-
dc.identifier.scopuseid_2-s2.0-74749109133en_HK
dc.identifier.hkuros168723en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-74749109133&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume195en_HK
dc.identifier.issue1-3en_HK
dc.identifier.spage93en_HK
dc.identifier.epage98en_HK
dc.identifier.eissn1872-6283-
dc.identifier.isiWOS:000273986100015-
dc.publisher.placeIrelanden_HK
dc.identifier.scopusauthoridFan, JKM=23484820100en_HK
dc.identifier.scopusauthoridTong, DKH=8670837000en_HK
dc.identifier.scopusauthoridPoon, JTC=7005903722en_HK
dc.identifier.scopusauthoridLo, OSH=6508168045en_HK
dc.identifier.scopusauthoridBeh, PSL=6603146797en_HK
dc.identifier.scopusauthoridPatil, NG=7103152514en_HK
dc.identifier.scopusauthoridLaw, WL=7103147867en_HK
dc.identifier.citeulike6474617-

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