Suction rectal biopsy yields adequate tissue in children

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Histopathology

Background:

• Hirschsprung disease (HD) diagnosis relies on rectal biopsy.
• Suction rectal biopsy (SRB) is preferred for neonates, but concerns exist regarding its efficacy in older children.
• Assessing SRB adequacy across different age groups is crucial for optimizing diagnostic yield.

Purpose of the Study:

• To evaluate the adequacy of suction rectal biopsy (SRB) for diagnosing Hirschsprung disease (HD) in pediatric patients.
• To determine if patient age influences the success rate of SRB.
• To assess the current device's effectiveness in a pediatric cohort.

Main Methods:

• Retrospective cohort study of 56 children (1-18 years) undergoing SRB for suspected HD.
• Data collected included demographics, procedure details, results, and complications.
• Statistical analysis performed using SPSS.

Main Results:

• Overall SRB adequacy rate was 80.4% (45/56 children).
• Patients older than 5 years demonstrated a higher adequacy rate (90.5%) compared to younger patients (74.3%).
• Adequacy was not associated with insurance, race, weight-height, BMI, sedation type, or procedure location; however, younger age and male sex showed a weak association with inadequate specimens.

Conclusions:

• Suction rectal biopsy (SRB) demonstrates significant effectiveness in diagnosing Hirschsprung disease (HD) in older children, achieving 90.5% adequacy in patients over 5 years.
• The overall adequacy rate of 80.4% supports SRB as a valuable diagnostic tool across a wide pediatric age range.
• Inadequate initial biopsies were successfully diagnosed with modified SRB techniques or full-thickness biopsies under general anesthesia.