Skip to main content
Erschienen in: Pediatric Surgery International 11/2016

01.09.2016 | Original Article

Pathological changes of interstitial cells of Cajal and ganglion cells in the segment of resected bowel in Hirschsprung’s disease

verfasst von: Xuyong Chen, Hongyi Zhang, Ning Li, Jiexiong Feng

Erschienen in: Pediatric Surgery International | Ausgabe 11/2016

Einloggen, um Zugang zu erhalten

Abstract

Objectives

This study was conducted to investigate the pathological changes which occur in interstitial cells of Cajal (ICCs) and ganglion cells found in segments of resected bowel obtained from patients with Hirschsprung’s disease (HD), as well as to explore the benefits of using a contrast enema (CE) with 24-h delayed X-ray films to predict the length of resected bowel.

Methods

We performed a retrospective analysis of 58 children with HD who had undergone the pull-through procedure. After each operation, the ICCs and ganglion cells present in the proximal ends of the barium residue (Level A) and resected proximal bowel segment (Level B) were analyzed using immunohistochemical staining methods. Each patient was followed up for 1 year to record their stool frequency, defecation control ability, and post-surgical complications which may have occurred.

Results

Immunohistochemical staining detected fewer ICCs in Level A than in Level B (p < 0.05). However, the density of ganglion cells in the two levels was not significantly different (p > 0.05). One patient had anastomotic stricture, and five patients suffered from enterocolitis.

Conclusions

The density of ICCs was significantly lower in the bowel segments that displayed barium retention. A CE may be a valuable tool for predicting the length of bowel resection in patients with HD.
Literatur
1.
3.
Zurück zum Zitat Coe A, Collins MH, Lawal T et al (2012) Reoperation for Hirschsprung disease: pathology of the resected problematic distal pull-through. Pediatr Dev Pathol 15(1):30–38CrossRefPubMed Coe A, Collins MH, Lawal T et al (2012) Reoperation for Hirschsprung disease: pathology of the resected problematic distal pull-through. Pediatr Dev Pathol 15(1):30–38CrossRefPubMed
4.
Zurück zum Zitat Friedmacher F, Puri P (2011) Residual aganglionosis after pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis. Pediatr Surg Int 27(10):1053–1057CrossRefPubMed Friedmacher F, Puri P (2011) Residual aganglionosis after pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis. Pediatr Surg Int 27(10):1053–1057CrossRefPubMed
5.
Zurück zum Zitat Gfroerer S, Rolle U (2013) Interstitial cells of Cajal in the normal human gut and in Hirschsprung disease. Pediatr Surg Int 29(9):889–897CrossRefPubMed Gfroerer S, Rolle U (2013) Interstitial cells of Cajal in the normal human gut and in Hirschsprung disease. Pediatr Surg Int 29(9):889–897CrossRefPubMed
6.
Zurück zum Zitat Wang H, Zhang Y, Liu W et al (2009) Interstitial cells of Cajal reduce in number in recto-sigmoid Hirschsprung’s disease and total colonic aganglionosis. Neurosci Lett 451(3):208–211CrossRefPubMed Wang H, Zhang Y, Liu W et al (2009) Interstitial cells of Cajal reduce in number in recto-sigmoid Hirschsprung’s disease and total colonic aganglionosis. Neurosci Lett 451(3):208–211CrossRefPubMed
7.
Zurück zum Zitat Frongia G, Günther P, Schenk JP et al (2016) Contrast Enema for Hirschsprung disease investigation: diagnostic accuracy and validity for subsequent diagnostic and surgical planning. Eur J Pediatr Surg 26(2):207–214PubMed Frongia G, Günther P, Schenk JP et al (2016) Contrast Enema for Hirschsprung disease investigation: diagnostic accuracy and validity for subsequent diagnostic and surgical planning. Eur J Pediatr Surg 26(2):207–214PubMed
8.
Zurück zum Zitat Pratap A, Gupta DK, Tiwari A et al (2007) Application of a plain abdominal radiograph transition zone (PARTZ) in Hirschsprung’s disease. BMC Pediatr 7:5CrossRefPubMedPubMedCentral Pratap A, Gupta DK, Tiwari A et al (2007) Application of a plain abdominal radiograph transition zone (PARTZ) in Hirschsprung’s disease. BMC Pediatr 7:5CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Wong CW, Lau CT, Chung PH et al (2015) The value of the 24-h delayed abdominal radiograph of barium enema in the diagnosis of Hirschsprung’s disease. Pediatr Surg Int 31(1):11–15CrossRefPubMed Wong CW, Lau CT, Chung PH et al (2015) The value of the 24-h delayed abdominal radiograph of barium enema in the diagnosis of Hirschsprung’s disease. Pediatr Surg Int 31(1):11–15CrossRefPubMed
10.
Zurück zum Zitat Yang S, Donner LR (2002) Detection of ganglion cells in the colonic plexuses by immunostaining forneuron-specific marker NeuN: an aid for the diagnosis of Hirschsprung disease. Appl Immunohistochem Mol Morphol 10:218–220PubMed Yang S, Donner LR (2002) Detection of ganglion cells in the colonic plexuses by immunostaining forneuron-specific marker NeuN: an aid for the diagnosis of Hirschsprung disease. Appl Immunohistochem Mol Morphol 10:218–220PubMed
11.
Zurück zum Zitat de Lorijn F, Kremer LC, Reitsma JB, Benninga MA (2006) Diagnostic tests in Hirschsprung disease: a systematic review. J Pediatr Gastroenterol Nutr 42(5):496–505CrossRefPubMed de Lorijn F, Kremer LC, Reitsma JB, Benninga MA (2006) Diagnostic tests in Hirschsprung disease: a systematic review. J Pediatr Gastroenterol Nutr 42(5):496–505CrossRefPubMed
12.
Zurück zum Zitat Zhang HY, Feng JX, Huang L et al (2008) Diagnosis and surgical treatment of isolated hypoganglionosis. World J Pediatr 4(4):295–300CrossRefPubMed Zhang HY, Feng JX, Huang L et al (2008) Diagnosis and surgical treatment of isolated hypoganglionosis. World J Pediatr 4(4):295–300CrossRefPubMed
13.
Zurück zum Zitat Yamataka A, Kato Y, Tibboel D et al (1995) A lack of intestinal pacemaker (c-kit) in aganglionic bowel of patients with Hirschsprung’s disease. J Pediatr Surg 30(3):441–444CrossRefPubMed Yamataka A, Kato Y, Tibboel D et al (1995) A lack of intestinal pacemaker (c-kit) in aganglionic bowel of patients with Hirschsprung’s disease. J Pediatr Surg 30(3):441–444CrossRefPubMed
14.
Zurück zum Zitat Rolle U, Piotrowska AP, Nemeth L, Puri P (2002) Altered distribution of interstitial cells of Cajal in Hirschsprung disease. Arch Pathol Lab Med 126(8):928–933PubMed Rolle U, Piotrowska AP, Nemeth L, Puri P (2002) Altered distribution of interstitial cells of Cajal in Hirschsprung disease. Arch Pathol Lab Med 126(8):928–933PubMed
15.
Zurück zum Zitat Rolle U, Piaseczna-Piotrowska A, Puri P (2007) Interstitial cells of Cajal in the normal gut and in intestinal motility disorders of childhood. Pediatr Surg Int 23(12):1139–1152CrossRefPubMed Rolle U, Piaseczna-Piotrowska A, Puri P (2007) Interstitial cells of Cajal in the normal gut and in intestinal motility disorders of childhood. Pediatr Surg Int 23(12):1139–1152CrossRefPubMed
16.
Zurück zum Zitat Vanderwinden JM, Rumessen JJ, Liu H et al (1996) Interstitial cells of Cajal in human colon and in Hirschsprung’s disease. Gastroenterology 111(4):901–910CrossRefPubMed Vanderwinden JM, Rumessen JJ, Liu H et al (1996) Interstitial cells of Cajal in human colon and in Hirschsprung’s disease. Gastroenterology 111(4):901–910CrossRefPubMed
17.
Zurück zum Zitat Proctor ML, Traubici J, Langer JC et al (2003) Correlation between radiographic transition zone and level of aganglionosis in Hirschsprung’s disease: implications for surgical approach. J Pediatr Surg 38(5):775–778CrossRefPubMed Proctor ML, Traubici J, Langer JC et al (2003) Correlation between radiographic transition zone and level of aganglionosis in Hirschsprung’s disease: implications for surgical approach. J Pediatr Surg 38(5):775–778CrossRefPubMed
18.
Zurück zum Zitat Kapur RP, Kennedy AJ (2012) Transitional zone pull through: surgical pathology considerations. Semin Pediatr Surg 21(4):291–301CrossRefPubMed Kapur RP, Kennedy AJ (2012) Transitional zone pull through: surgical pathology considerations. Semin Pediatr Surg 21(4):291–301CrossRefPubMed
19.
Zurück zum Zitat Langer JC (2012) Laparoscopic and transanal pull-through for Hirschsprung disease. Semin Pediatr Surg 21(4):283–290CrossRefPubMed Langer JC (2012) Laparoscopic and transanal pull-through for Hirschsprung disease. Semin Pediatr Surg 21(4):283–290CrossRefPubMed
20.
Zurück zum Zitat Bettolli M, Rubin SZ, Staines W et al (2006) The use of rapid assessment of enteric ICC and neuronal morphology may improve patient management in pediatric surgery: a new clinical pathological protocol. Pediatr Surg Int 22(1):78–83CrossRefPubMed Bettolli M, Rubin SZ, Staines W et al (2006) The use of rapid assessment of enteric ICC and neuronal morphology may improve patient management in pediatric surgery: a new clinical pathological protocol. Pediatr Surg Int 22(1):78–83CrossRefPubMed
21.
Zurück zum Zitat Langer J, Caty M, de la Torre-Mondragon L et al (2007) IPEG colorectal panel. J Laparoendosc Adv Surg Tech A 17(1):77–100CrossRefPubMed Langer J, Caty M, de la Torre-Mondragon L et al (2007) IPEG colorectal panel. J Laparoendosc Adv Surg Tech A 17(1):77–100CrossRefPubMed
Metadaten
Titel
Pathological changes of interstitial cells of Cajal and ganglion cells in the segment of resected bowel in Hirschsprung’s disease
verfasst von
Xuyong Chen
Hongyi Zhang
Ning Li
Jiexiong Feng
Publikationsdatum
01.09.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Surgery International / Ausgabe 11/2016
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-016-3961-7

Weitere Artikel der Ausgabe 11/2016

Pediatric Surgery International 11/2016 Zur Ausgabe

Kinder mit anhaltender Sinusitis profitieren häufig von Antibiotika

30.04.2024 Rhinitis und Sinusitis Nachrichten

Persistieren Sinusitisbeschwerden bei Kindern länger als zehn Tage, ist eine Antibiotikatherapie häufig gut wirksam: Ein Therapieversagen ist damit zu über 40% seltener zu beobachten als unter Placebo.

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

23.04.2024 Typ-1-Diabetes Nachrichten

Wenn Kinder an Werktagen zum Arzt gehen, werden neu auftretender Typ-1-Diabetes und diabetische Ketoazidosen häufiger erkannt als bei Arztbesuchen an Wochenenden oder Feiertagen.

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

22.04.2024 Fehlsichtigkeit Nachrichten

Augentropfen mit niedrig dosiertem Atropin können helfen, das Fortschreiten einer Kurzsichtigkeit bei Kindern zumindest zu verlangsamen, wie die Ergebnisse einer aktuellen Studie mit verschiedenen Dosierungen zeigen.

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

18.04.2024 Spinale Muskelatrophien Nachrichten

Seit 2021 ist die Untersuchung auf spinale Muskelatrophie Teil des Neugeborenen-Screenings in Deutschland. Eine Studie liefert weitere Evidenz für den Nutzen der Maßnahme.

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.