Intraoperative Rapid On‐Site Evaluation ( ROSE ) vs. Frozen Section in Lung Surgery: A Prospective Study on Diagnostic Speed and Accuracy

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INTRODUCTION: Frozen section (FS) is the most widely used method to assess resected pulmonary lesions intraoperatively, although it also prolongs the operation time. We aimed to evaluate the accuracy of intraoperative rapid on-site evaluation (ROSE) and evaluate whether it can serve as a faster auxiliary judgment alongside FS. METHODS: A prospective study was conducted on patients undergoing complete resection. Rapid Romanowsky (DiffQuik) staining was used for ROSE. The results of intraoperative ROSE were compared with those of frozen section and final pathological diagnosis. RESULTS: A total of 75 patients were enrolled in the study, and 81 samples were taken for ROSE, which could assess biopsied samples within a few minutes. The time required for ROSE is significantly shorter than that for intraoperative frozen section analysis, and the mean time to diagnosis was significantly shorter for ROSE (by surgeon) than for FS (9.75 min vs. 29.70 min, p < 0.001). The diagnostic accuracy of ROSE was 90.1% for surgeons, 95.6% for experienced pathologists, and 81.5% for junior pathologists, respectively. CONCLUSION: ROSE can serve as an auxiliary judgment tool, enabling frozen sections to make intraoperative decisions more rapidly. It is a valuable technique for diagnosing lung tumor intraoperatively.

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