Rectal suction biopsy with calretinin immunohistochemistry in patients suspected with residual aganglionosis after operation for Hirschsprung disease

• Published in: Journal of pediatric surgery 2017-10, Vol.52 (10), p.1597-1601
• Main Authors: Tran, Viet Quoc, Truong, Dinh Quang, Goyens, Philippe, Steyaert, Henri
• Format: Article
• Language: English
• Subjects: Adolescent; Biopsy - methods; Calbindin 2 - metabolism; Calretinin immunohistochemistry; Child; Child, Preschool; Digestive System Surgical Procedures; Female; Hirschsprung disease; Hirschsprung Disease - metabolism; Hirschsprung Disease - surgery; Humans; Immunohistochemistry; Infant; Male; Outcome Assessment (Health Care); Rectal suction biopsy; Rectum - chemistry; Rectum - pathology; Residual aganglionosis; Suction; Transition zone bowel; Young Adult
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2017.02.016

This study investigates the use of rectal suction biopsy (RSB) with calretinin immunohistochemical staining (CIS) in patients suspected of having abnormally innervated bowel after pull through operation for Hirschsprung disease (HD). This study was conducted in Children's Hospital 2, Ho Chi Minh City from January 2015 through June 2016. Patients suspected with abnormally innervated bowel after pull through operation for HD were submitted for a RSB with CIS. Following histological results, the patients underwent an appropriate treatment (redo pull through operation or non-operative medical management) and followed up at least 6 months to evaluate their outcomes. Ten patients were enrolled in our study. The median age was 5.6 (range 1.4–20) years. The diagnosis of normally innervated bowel was made in five patients by showing positive reactivity of CIS on RSB, whereas five others were diagnosed with abnormally innervated bowel. Final diagnosis of the five latter patients was confirmed by analyses of the resected bowel after a redo pull through operation (including 4 cases with residual aganglionosis and one case with transition zone bowel). RSB with CIS is a reliable and simple method for diagnosis of abnormally innervated bowel after pull through operation for HD. III Study of diagnostic test (evaluate the effectiveness of a diagnostic test or outcome assessment).