Rectal Biopsy for Hirschsprung’s Disease: A Multicentre Study Involving Biopsy Technique, Pathology and Complications
Background: The heterogeneity of rectal biopsy techniques has encouraged us to search for a surgical and pathological standardisation of this diagnostic technique to exclude Hirschsprung’s disease. The different amounts of information on the anatomopathology report prompted us to compile a template...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/9/1488 |
| _version_ | 1827726770320703488 |
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| author | Gil Vervloet Antoine De Backer Stijn Heyman Paul Leyman Sebastiaan Van Cauwenberge Kim Vanderlinden Charlotte Vercauteren Dirk Vervloessem Marc Miserez |
| author_facet | Gil Vervloet Antoine De Backer Stijn Heyman Paul Leyman Sebastiaan Van Cauwenberge Kim Vanderlinden Charlotte Vercauteren Dirk Vervloessem Marc Miserez |
| author_sort | Gil Vervloet |
| collection | DOAJ |
| description | Background: The heterogeneity of rectal biopsy techniques has encouraged us to search for a surgical and pathological standardisation of this diagnostic technique to exclude Hirschsprung’s disease. The different amounts of information on the anatomopathology report prompted us to compile a template for the anatomopathology report for diagnostic rectal biopsies for surgical colleagues and pathologists working on Hirschsprung’s disease. Methods: We gathered the anonymous biopsy information and its pathology information from five hospitals for all patients in which rectal biopsies were taken to diagnose Hirschsprung’s disease over two years (2020–2021). Results: Of the 82 biopsies, 20 suction (24.4%), 31 punch (37.8%) and 31 open biopsies (37.8%) were taken. Of all biopsies, 69 were conclusive (84.2%), 13 were not (15.8%). In the suction biopsy group, 60% were conclusive and 40% were not; for punch biopsy, the values were 87% and 13%, respectively and for open biopsy, 97% and 3%. Inconclusive results were due to insufficient submucosa in 6/8 suction biopsies, 4/4 punch biopsies and 0/1 open biopsies. An insufficient amount of submucosa was the reason for an inconclusive result in 6/20 cases (30%) after suction biopsy, 4/31 (12.9%) cases after punch biopsy and 0 cases (0%) after open biopsy. We had one case with major postoperative bleeding post suction biopsy; there were no further adverse effects after biopsy. Conclusions: Diagnostic rectal biopsies in children are safe. Non-surgical biopsies are more likely to give inconclusive results due to smaller amounts of submucosa present in the specimen. Open biopsies are especially useful when previous non-surgical biopsies are inconclusive. An experienced pathologist is a key factor for the result. The anatomopathology report should specify the different layers present in the specimen, the presence of ganglion cells and hypertrophic nerve fibres, their description and a conclusion. |
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| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T22:55:32Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-b2cfd5fc86c4403fa10716d8de5663492023-11-19T10:03:11ZengMDPI AGChildren2227-90672023-08-01109148810.3390/children10091488Rectal Biopsy for Hirschsprung’s Disease: A Multicentre Study Involving Biopsy Technique, Pathology and ComplicationsGil Vervloet0Antoine De Backer1Stijn Heyman2Paul Leyman3Sebastiaan Van Cauwenberge4Kim Vanderlinden5Charlotte Vercauteren6Dirk Vervloessem7Marc Miserez8Universitair Ziekenhuis Leuven, Katholieke Universiteit Leuven, 3000 Leuven, BelgiumUniversitair Ziekenhuis Brussel, KidZ Health Castle, Saffier Network, 1000 Brussels, BelgiumZiekenhuis Netwerk Antwerpen, Ziekenhuis aan de Stroom, Queen Paola Children’s Hospital, Saffier Network, 2650 Edegem, BelgiumGasthuiszusters Antwerpen, Ziekenhuis aan de Stroom, Saffier Network, 2000 Antwerpen, BelgiumAlgemeen Ziekenhuis Sint-Jan, 8000 Brugge, BelgiumUniversitair Ziekenhuis Brussel, KidZ Health Castle, Saffier Network, 1000 Brussels, BelgiumUniversitair Ziekenhuis Brussel, KidZ Health Castle, Saffier Network, 1000 Brussels, BelgiumZiekenhuis Netwerk Antwerpen, Ziekenhuis aan de Stroom, Queen Paola Children’s Hospital, Saffier Network, 2650 Edegem, BelgiumUniversitair Ziekenhuis Leuven, Katholieke Universiteit Leuven, 3000 Leuven, BelgiumBackground: The heterogeneity of rectal biopsy techniques has encouraged us to search for a surgical and pathological standardisation of this diagnostic technique to exclude Hirschsprung’s disease. The different amounts of information on the anatomopathology report prompted us to compile a template for the anatomopathology report for diagnostic rectal biopsies for surgical colleagues and pathologists working on Hirschsprung’s disease. Methods: We gathered the anonymous biopsy information and its pathology information from five hospitals for all patients in which rectal biopsies were taken to diagnose Hirschsprung’s disease over two years (2020–2021). Results: Of the 82 biopsies, 20 suction (24.4%), 31 punch (37.8%) and 31 open biopsies (37.8%) were taken. Of all biopsies, 69 were conclusive (84.2%), 13 were not (15.8%). In the suction biopsy group, 60% were conclusive and 40% were not; for punch biopsy, the values were 87% and 13%, respectively and for open biopsy, 97% and 3%. Inconclusive results were due to insufficient submucosa in 6/8 suction biopsies, 4/4 punch biopsies and 0/1 open biopsies. An insufficient amount of submucosa was the reason for an inconclusive result in 6/20 cases (30%) after suction biopsy, 4/31 (12.9%) cases after punch biopsy and 0 cases (0%) after open biopsy. We had one case with major postoperative bleeding post suction biopsy; there were no further adverse effects after biopsy. Conclusions: Diagnostic rectal biopsies in children are safe. Non-surgical biopsies are more likely to give inconclusive results due to smaller amounts of submucosa present in the specimen. Open biopsies are especially useful when previous non-surgical biopsies are inconclusive. An experienced pathologist is a key factor for the result. The anatomopathology report should specify the different layers present in the specimen, the presence of ganglion cells and hypertrophic nerve fibres, their description and a conclusion.https://www.mdpi.com/2227-9067/10/9/1488Hirschsprung’s diseaserectal biopsysuction biopsypunch biopsypathology Hirschsprung |
| spellingShingle | Gil Vervloet Antoine De Backer Stijn Heyman Paul Leyman Sebastiaan Van Cauwenberge Kim Vanderlinden Charlotte Vercauteren Dirk Vervloessem Marc Miserez Rectal Biopsy for Hirschsprung’s Disease: A Multicentre Study Involving Biopsy Technique, Pathology and Complications Children Hirschsprung’s disease rectal biopsy suction biopsy punch biopsy pathology Hirschsprung |
| title | Rectal Biopsy for Hirschsprung’s Disease: A Multicentre Study Involving Biopsy Technique, Pathology and Complications |
| title_full | Rectal Biopsy for Hirschsprung’s Disease: A Multicentre Study Involving Biopsy Technique, Pathology and Complications |
| title_fullStr | Rectal Biopsy for Hirschsprung’s Disease: A Multicentre Study Involving Biopsy Technique, Pathology and Complications |
| title_full_unstemmed | Rectal Biopsy for Hirschsprung’s Disease: A Multicentre Study Involving Biopsy Technique, Pathology and Complications |
| title_short | Rectal Biopsy for Hirschsprung’s Disease: A Multicentre Study Involving Biopsy Technique, Pathology and Complications |
| title_sort | rectal biopsy for hirschsprung s disease a multicentre study involving biopsy technique pathology and complications |
| topic | Hirschsprung’s disease rectal biopsy suction biopsy punch biopsy pathology Hirschsprung |
| url | https://www.mdpi.com/2227-9067/10/9/1488 |
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