Suction Rectal Biopsy is Accurate in Late Preterm Infants with Suspected Hirschsprung Disease

Halleran, Devin R.; Ahmad, Hira; Lehmkuhl, Haley; Baker, Peter; Wood, Richard J.; Levitt, Marc A.; Fisher, Jeremy G.

doi:10.1016/j.jpedsurg.2019.09.055

Cited by 8 publications

(5 citation statements)

References 16 publications

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“…During the follow-up period, no child with ganglionosis in biopsies was found to have HD. These high sensitivity and specificity results are in accordance with some previous studies [ 19 , 20 ], while two systemic reviews reported marginally lower RSB mean sensitivities (93% and 97%) and specificities (98% and 99%) [ 5 , 21 ]. The differences in outcome might be due to different definitions of efficacy, sensitivity/specificity, staining techniques, or follow-up periods.…”

Section: Discussionsupporting

confidence: 92%

Diagnostic Efficacy of Rectal Suction Biopsy with Regard to Weight in Children Investigated for Hirschsprung’s Disease

et al. 2022

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Background/aim: Diagnostic efficacy, defined as the percentage of rectal suction biopsy (RSB) specimens sufficient enough to determine the absence of ganglia cells in Hirschsprung’s disease (HD) diagnosis, has been reported to be low, requiring repeated biopsies. The aim was to explore whether RSB diagnostic efficacy was influenced by the child’s weight and to ascertain whether RSB efficacy differed between aganglionic and ganglionic tissue. Materials and Methods: Efficacy analyses were conducted in a national HD-center’s register on children 0–15 kg, examined between 2011–2019. First-time RSB diagnostic efficacy was correlated to the children’s weight and final HD diagnosis. Results: Among the 84 children who had first-time RSB, the overall diagnostic efficacy was 85% (71/84). The efficacy was higher among children weighing less than the identified cut-off of 9.0 kg (89% in 0–9.0 kg versus 62% in 9.01–15.0 kg, p = 0.026). Among children diagnosed with HD, 96% (26/27) weighed 0–9.0 kg. In this weight group, the diagnostic efficacy was lower in aganglionosis compared to ganglionosis (77%; 20/26 versus 96%; 43/45), p = 0.045). Conclusions: The RSB diagnostic efficacy was significantly higher in children weighing less than 9.0 kg and was less in aganglionic compared to ganglionic tissue. Therefore, weight can be useful to predict RSB diagnostic efficacy.

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Section: Discussionsupporting

confidence: 92%

Diagnostic Efficacy of Rectal Suction Biopsy with Regard to Weight in Children Investigated for Hirschsprung’s Disease

et al. 2022

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“…A variety of forceps models, technical modifications, and new biopsy methods have been proposed to provide deeper and larger rectal specimens to improve the conclusive rates (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20); however, the risk of complications increases directly with the size of the biopsy specimen (9,10,21). Currently, the most used biopsy techniques are open surgical, punch, suction, and endoscopic, but suction techniques are the most widely used (22).…”

Section: What Is Newmentioning

confidence: 99%

Rectal Biopsy Technique for the Diagnosis of Hirschsprung Disease in Children

Comes¹,

Ortolan²,

Moreira

et al. 2021

J. pediatr. gastroenterol. nutr.

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The diagnosis of Hirschsprung disease (HD) depends on the histopathological analysis of rectal biopsies. This review aims to define the best rectal biopsy technique. A systematic literature review and proportional meta-analysis of the available case series studies of rectal biopsies were performed in this study. All case series with more than five rectal biopsies in children younger than 18 years of age suspected of HD that described at least one type of rectal biopsy were included. The studies that did not specify the rate of conclusive results and the rate of complications of the biopsy procedures were excluded. According to the literature review, there were four different techniques of rectal biopsy: open, suction, punch, and endoscopic. In the title and abstract screening process, we assessed 496 articles, 159 fulfilled the eligibility criteria, and 71 studies reported our outcomes of interest and were included in the meta-analysis. The pooled proportion of conclusive results was 94% in open biopsies (95% CI 0.89–0.98), 95% in punch (95% CI 0.90–0.98), and 88% in suction group (95% CI 0.85–0.92). The pooled proportion of complication rates was 2% in open biopsies (95% CI 0.00031–0.04), 0.039% in suction (95% CI 0.00023–0.0006), and 2% in punch biopsies (95% CI 0.00075–0.04). Suction, punch, and open techniques presented comparable rates of conclusive results. In the suction group, the association between different methods of histopathological analysis increased conclusive results rates; however, the punch biopsy was associated with significantly higher complication rates than the suction technique.

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“…review the RSB of PHD in their institute believed that suction rectal biopsy can be performed safely in preterm infants as small as 1590-2000 g with high accuracy. Clinicians should not hesitate to perform a biopsy for a premature infant when clinically appropriate [13]. In our cases, there were 10 patients who were less than 37 gestational weeks at the time of biopsy.…”

Section: Discussionmentioning

confidence: 90%

Safety and Accuracy of Suction Rectal Biopsy in Preterm Infants

Zhang

Huang

Chen

et al. 2020

Preprint

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Purpose: Little attention were paid in the diagnosis of preterm infants with Hirschsprung disease (HD) in most pediatric surgeons. We aimed to explore the safety and accuracy of suction rectal biopsy (SRB) in preterm infants.Methods: A retrospective review was conducted on 45 preterm patients who underwent SRB from 2015 to 2019 in our hospital. We collected the clinical characteristics and pathology results of the patients, and followed up. The sensitivity and specificity of SRB for HD diagnosis were calculated.Results: The median gestational age of the patients was 35 weeks (range: 28.9 to 36.9 weeks) while the median gestational age at biopsy was 38.6 weeks (range: 33.4 to 60.0 weeks), and the median weight was 2790 g (range: 1580 to 4100 g). Fifteen cases (33.3%) were positive for HD which were confirmed after the pull-through surgery. The ganglion cells presented on 30 cases. And the diagnosis of HD was excluded in 29 patients after discharge follow-up. The sensitivity was supposed to be 93.7%-100% and specificity was 100%. Among the patients whose biopsy age is < 37 weeks (10 cases) or biopsy weight is < 2000 g (5 cases), no complications occurred after SRB.Conclusion: SRB is safe and accurate in late preterm infants.

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Suction Rectal Biopsy is Accurate in Late Preterm Infants with Suspected Hirschsprung Disease

Cited by 8 publications

References 16 publications

Diagnostic Efficacy of Rectal Suction Biopsy with Regard to Weight in Children Investigated for Hirschsprung’s Disease

Diagnostic Efficacy of Rectal Suction Biopsy with Regard to Weight in Children Investigated for Hirschsprung’s Disease

Rectal Biopsy Technique for the Diagnosis of Hirschsprung Disease in Children

Safety and Accuracy of Suction Rectal Biopsy in Preterm Infants

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