Nicole Green1, Caitlin A Smith2, Miranda C Bradford3, Lusine Ambartsumyan4, Raj P Kapur5. 1. Department of Gastroenterology, Seattle Children's Hospital and the University of Washington, 4800 Sand Point Way NE, OB. 9.620, PO Box 5371, Seattle, WA, 98145-5005, USA. Nicole.green@seattlechildrens.org. 2. Department of Surgery, Seattle Children's Hospital and the University of Washington, Seattle, WA, USA. 3. Core for Biostatistics Epidemiology and Analytics in Research, Seattle Children's Research Institute, Seattle, WA, USA. 4. Department of Gastroenterology, Seattle Children's Hospital and the University of Washington, 4800 Sand Point Way NE, OB. 9.620, PO Box 5371, Seattle, WA, 98145-5005, USA. 5. Department of Laboratory Medicine and Pathology, Seattle Children's Hospital and the University of Washington, Seattle, WA, USA.
Abstract
BACKGROUND: Hirschsprung disease is one of the most common congenital anomalies that affect colorectal function. Rectal biopsy demonstrating the absence of ganglion cells in the affected bowel is the gold standard for diagnosis. Suction and incisional rectal biopsies are appropriate methods for obtaining diagnostic tissue. The goal of this study is to determine if any differences in adequacy exist between suction and incisional rectal biopsies at our institution. METHODS: We conducted a retrospective review of suction and incisional rectal biopsies for inadequacy per procedure at a tertiary pediatric hospital. Each procedure for rectal biopsy was also evaluated by a number of biopsies per procedure. We used a two-sample test of proportions to compare the inadequacy of suction vs. incisional biopsies. RESULTS: 133 rectal suction biopsy procedures (227 biopsies) and 125 incisional biopsy procedures (140 biopsies) were analyzed. In patients 6 months of age and older, the percentage of inadequate procedures was substantially higher in the suction biopsy group (24.1% vs 0.9%, p < 0.01). CONCLUSIONS: A substantially higher proportion of inadequacy was found in the suction rectal biopsy group compared to the incisional cohort among the older patient cohort, suggesting incisional biopsies should be strongly considered as the primary rectal biopsy method in patients older than 6 months.
BACKGROUND: Hirschsprung disease is one of the most common congenital anomalies that affect colorectal function. Rectal biopsy demonstrating the absence of ganglion cells in the affected bowel is the gold standard for diagnosis. Suction and incisional rectal biopsies are appropriate methods for obtaining diagnostic tissue. The goal of this study is to determine if any differences in adequacy exist between suction and incisional rectal biopsies at our institution. METHODS: We conducted a retrospective review of suction and incisional rectal biopsies for inadequacy per procedure at a tertiary pediatric hospital. Each procedure for rectal biopsy was also evaluated by a number of biopsies per procedure. We used a two-sample test of proportions to compare the inadequacy of suction vs. incisional biopsies. RESULTS: 133 rectal suction biopsy procedures (227 biopsies) and 125 incisional biopsy procedures (140 biopsies) were analyzed. In patients 6 months of age and older, the percentage of inadequate procedures was substantially higher in the suction biopsy group (24.1% vs 0.9%, p < 0.01). CONCLUSIONS: A substantially higher proportion of inadequacy was found in the suction rectal biopsy group compared to the incisional cohort among the older patient cohort, suggesting incisional biopsies should be strongly considered as the primary rectal biopsy method in patients older than 6 months.
Authors: Joseph M Croffie; Mary M Davis; Philip R Faught; Mark R Corkins; Sandeep K Gupta; Marian D Pfefferkorn; Jean P Molleston; Joseph F Fitzgerald Journal: J Pediatr Gastroenterol Nutr Date: 2007-02 Impact factor: 2.839
Authors: Giovana Tuccille Comes; Erika Veruska Paiva Ortolan; Maressa Maria de Medeiros Moreira; Wilson Elias de Oliveira Junior; Marcos Curcio Angelini; Regina El Dib; Pedro Luiz Toledo de Arruda Lourenção Journal: J Pediatr Gastroenterol Nutr Date: 2021-04-01 Impact factor: 2.839