Tao Boyuan,Chen Kai,Zeng Jixiao,et al.Application of stratified rectal biopsy for refractory constipation in children[J].Journal of Clinical Pediatric Surgery,,():814-818.[doi:10.3760/cma.j.cn101785-202306037-003]
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Application of stratified rectal biopsy for refractory constipation in children

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: Number: 2024 09 Page: 814-818 Column: 专题·外科便秘性疾病 Date of publication: 2024-09-01
Author(s):
Tao Boyuan1;  Chen Kai2;  Zeng Jixiao1;  Liu Fei1;  Xu Xiaogang1;  Lan Menglong1;  Liang Zijian1;  Zhong Zhizu1;  Lin Yuzhen3;  Lin Ruiyan3
1. Department of Gastrointestinal Surgery, Municipal Women & Children’s Medical Center, Guangzhou Medical University, National Children’s Regional Medical Center, Guangzhou 510120, China;
2. Department of Pathology, Municipal Women & Children’s Medical Center, Guangzhou Medical University, National Children’s Regional Medical Center, Guangzhou 510120, China;
3. Operating Room, Municipal Women & Children’s Medical Center, Guangzhou Medical University, National Children’s Regional Medical Center, Guangzhou 510120, China
Keywords:
Constipation; Biopsy; Pathology;  Surgical; Child
DOI:
10.3760/cma.j.cn101785-202306037-003
Abstract:
Objective To introduce a novel method of rectal full thickness biopsy and compare it with traditional method to further improve the satisfaction of pathological sampling for refractory constipation (RC) in children. Methods From December 2019 to December 2022,a total of 269 RC children were hospitalized.According to the inclusion criteria,the relevant clinical data were retrospectively reviewed for 217 cases.Traditional full thickness rectal biopsy (traditional group,n=92) and stratified rectal biopsy (stratified group,n=125) were performed.Baseline profiles,intraoperative findings and compliance rate of pathological sampling were compared between two groups. Results All operations were completed successfully.Operative age[(10.9±2.8) vs.(10.4±2.7) month],volume of blood loss[(4.6±1.9) vs.(5.1±1.7) ml]and postoperative hospitalization stay[(1.6±0.6) vs.(1.7±0.5) day]showed no significant inter-group differences(P>0.05).Significant inter-group difference existed in compliance rate of sampling[88.0%(81/92) vs.100%(125/125)]and operative duration[(29.3±6.6) vs.(34.7±5.6) min](P<0.05). Conclusions Stratified rectal biopsy may significantly improve the compliance rate of sampling and avoid pathological diagnostic difficulties of insufficient sampling.

References:

[1] 张文,武海燕,李惠,等.先天性巨结肠病理诊断规范[J].中华病理学杂志,2016,45(3):149-152.DOI:10.3760/cma.j.issn.0529-5807.2016.03.002. Zhang W,Wu HY,Li H,et al.Pathological diagnostic criteria for Hirschsprung’s disease[J].Chin J Pathol,2016,45(3):149-152.DOI:10.3760/cma.j.issn.0529-5807.2016.03.002.
[2] 曾纪晓,徐晓钢.先天性巨结肠诊疗规范化的再思考[J].临床小儿外科杂志,2021,20(3):201-207.DOI:10.12260/lcxewkzz.2021.03.001. Zeng JX,Xu XG.Some focal issues of standardizing the diagnosis and treatment of Hirschsprung’s disease[J].J Clin Ped Sur,2021,20(3):201-207.DOI:10.12260/lcxewkzz.2021.03.001.
[3] 张树成,白玉作.儿童便秘的治疗手段及应用指征[J].临床小儿外科杂志,2020,19(1):12-17,25.DOI:10.3969/j.issn.1671-6353.2020.01.003. Zhang SC,Bai YZ.Treatment modes of pediatric constipation and indications for its application[J].J Clin Ped Sur,2020,19(1):12-17,25.DOI:10.3969/j.issn.1671-6353.2020.01.003.
[4] Swenson O,Fisher JH,Macmahon HE.Rectal biopsy as an aid in the diagnosis of Hirschsprung’s disease[J].N Engl J Med,1955,253(15):632-635.DOI:10.1056/NEJM195510132531502.
[5] 中华医学会小儿外科学分会肛肠学组、新生儿学组.先天性巨结肠的诊断及治疗专家共识[J].中华小儿外科杂志,2017,38(11):805-815.DOI:10.3760/cma.j.issn.0253-3006.2017.11.002. Group of Anorectum and Neonatology,Society of Pediatric Surgery,Chinese Medical Association:Guidelines of Diagnosing and Treating Hirschspung’s disease[J].Chin J Pediatr Surg,2017,38(11):805-815.DOI:10.3760/cma.j.issn.0253-3006.2017.11.002.
[6] Kadowaki H,Kitano F,Takeuchi S,et al.Full-thickness rectal punch biopsy for the diagnosis of Hirschsprung’s disease[J].J Pediatr Surg,1979,14(2):165-168.DOI:10.1016/0022-3468(79)90011-3.
[7] Friedmacher F,Puri P.Rectal suction biopsy for the diagnosis of Hirschsprung’s disease:a systematic review of diagnostic accuracy and complications[J].Pediatr Surg Int,2015,31(9):821-830.DOI:10.1007/s00383-015-3742-8.
[8] Knowles CH,De Giorgio R,Kapur RP,et al.The London Classification of Gastrointestinal Neuromuscular Pathology:Report on Behalf of the Gastro 2009 International Working Group[J].Gut,2010,59(7):882-887.DOI:10.1136/gut.2009.200444.
[9] Friedmacher F,Puri P.Current practice patterns of rectal suction biopsy in the diagnostic work-up of Hirschsprung’s disease:results from an international survey[J].Pediatr Surg Int,2016,32(8):717-722.DOI:10.1007/s00383-016-3907-0.
[10] Redkar R,Chigicherla S,Tewari S,et al.Comparison between suction rectal biopsy and full-thickness rectal biopsy in the diagnosis of Hirschsprung’s disease[J].J Indian Assoc Pediatr Surg,2021,26(3):144-147.DOI:10.4103/jiaps.JIAPS_47_20.
[11] Bj?rn N,Rasmussen L,Qvist N,et al.Full-thickness rectal biopsy in children suspicious for Hirschsprung’s disease is safe and yields a low number of insufficient biopsies[J].J Pediatr Surg,2018,53(10):1942-1944.DOI:10.1016/j.jpedsurg.2018.01.005.
[12] Stewart CL,Kulungowski AM,Tong SH,et al.Rectal biopsies for Hirschsprung disease:Patient characteristics by diagnosis and attending specialty[J].J Pediatr Surg,2016,51(4):573-576.DOI:10.1016/j.jpedsurg.2015.10.047.
[13] 冯杰雄,蒙信尧,朱天琦.先天性巨结肠及其同源病诊断中的若干问题[J].临床小儿外科杂志,2018,17(2):81-85.DOI:10.3969/j.issn.1671-6353.2018.02.001. Feng JX,Meng XY,Zhu TQ.Various diagnostic issues of His-chsprung’s disease and its homologous diseases[J].J Clin Ped Sur,2018,17(2):81-85.DOI:10.3969/j.issn.1671-6353.2018.02.001.
[14] 兰梦龙,曾纪晓,徐晓钢,等.先天性巨结肠术后便秘复发再手术19例[J].临床小儿外科杂志,2021,20(3):230-235.DOI:10.12260/lcxewkzz.2021.03.006.

Memo

收稿日期:2023-7-22。
基金项目:国家自然科学基金(82170528);广东省自然科学基金(2022A1515012254);广州市科技计划市校(院)联合资助项目(202201020612);广州市临床特色技术项目(2023C-TS48);卫生健康技术重点推广项目(XM202403895)
通讯作者:曾纪晓,Email:zengjixiao@163.com

Last Update: 1900-01-01