结肠直肠活检:在直肠形时,它真的需要吗?
Emine Burcu Cigsar Kuzu1, Mustafa Onur Oztan2, Birsen Gizem Ozamrak3
1Department of Pediatric Surgery, Izmir Tepecik Training and Research Hospital, Izmir, Turkey. ebcigsar@gmail.com.
希尔施普伦格病 (HD) 和直肠形 (ARM) 之间的关联很少见. 在ARM患者中,常规组织学评估质不必要,可能导致误诊.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 病理学 病理学 病理学
背景情况:
- 赫施普隆病 (HD) 和门形 (ARM) 是先天性胃肠道异常.
- 罕见地报告了HD和ARM的共存.
- 当前的外科实践往往包括对ARM患者的腺组织学检查.
研究的目的:
- 为了调查ARM患者的HD的实际发病率.
- 评估是否需要在ARM标本中进行常规组织学检查,以检查ARM标本中的淋巴细胞.
- 为了防止ARM患者的潜在误诊和过度治疗.
主要方法:
- 在8年内对67名ARM患者的直肠样本进行了回顾性分析.
- 通过两位盲目的病理学家对47个样本进行了对状腺的存在和结构的组织病理学重新评估.
- 组织病理学发现与临床和放射学数据的相关性.
主要成果:
- 在分析的47个ARM标本中,51.1%显示正常的腺,29.7%具有腺病,而19.1%是不确定的.
- 没有任何结体样本表现出HD的其他组织学特征.
- 长期随访显示,在任何患者中都没有出现HD特异性并发症,无论其质状况如何.
结论:
- 在ARM和HD的同时发生非常罕见.
- 不建议在ARM标本中进行常规的格lia搜索.
- 阻止这种做法可以帮助避免误诊和在ARM管理中不必要的干预.
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