Meinds, R.J. (2014) Rectal suction biopsies in Hirschsprung’s disease: At what age are they reliable? thesis, Medicine.
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Abstract
Background International literature suggests that the outcome of the rectal suction biopsy for diagnosing Hirschsprung’s disease (HD) is related to the age of the patient. Despite this knowledge the internationally tendency is that children are operated at younger age after rectal suction biopsy diagnosis. The aim of this study is to determine at what age the rectal suction biopsy gives a reliable diagnosis. Methods A retrospective analysis was conducted on suspected HD patients who underwent one or more rectal suction biopsies between 1971 and 2011. Rectal suction biopsy outcomes were defined as positive for HD, uncertain, or negative for HD. The rectal suction biopsies were divided in 10 different groups (with equal number of biopsies), based on the age at which the biopsies were taken. The diagnosis made on the rectal suction biopsy was compared to the final diagnosis made after at least one year clinical follow-up. Results In total 538 rectal suction biopsies were included that were taken from 452 patients. Out of 452 patients 193 (42,7%) were diagnosed with HD after at least one year follow up. In patients younger than 5, 6-20 and 21-38 days old it was possible to correctly diagnose HD on rectal suction biopsy in respectively 50%, 46%, and 59% of the cases. HD was correctly excluded on rectal suction biopsy in these age groups in respectively 100%, 89%, and 95% of the cases. Results showed one false positive outcome of rectal suction biopsy. Conclusion These results show that there is little chance of false positive diagnosis leading to unnecessary surgical intervention. However, rectal suction biopsies taken below the age of 38 days have a significantly lower sensitivity for the diagnosis of HD and should be interpreted with caution. Biopsies at young age could lead to inconclusive results with the need of additional biopsies, exposing the patient to limited risks of additional complications.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Broens, Dr. P.M.A. and Heineman, Prof. dr. E. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:51 |
| Last Modified: | 25 Jun 2020 10:51 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1200 |
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