Zhang Yanan, Chen Yongwei, Yang Shen, Gu Yichao, Hua Kaiyun, Zhao Yong, Huang Jinshi
Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Front Pediatr. 2021 Aug 20;9:642342. doi: 10.3389/fped.2021.642342. eCollection 2021.
Most pediatric surgeons give little attention to the diagnosis of Hirschsprung disease (HD) in preterm infants. We aimed to explore the safety and accuracy of suction rectal biopsy (SRB) for diagnosing HD in preterm infants. A retrospective review was conducted of 45 preterm patients who underwent SRB from 2015 to 2019 in our hospital. We collected the clinical characteristics and pathology results of the patients and information on follow-up. The sensitivity and specificity of SRB for HD diagnosis were calculated. The median gestational age of the patients was 35 weeks (range: 28.9-36.9 weeks), the median gestational age at biopsy was 38.6 weeks (range: 33.4-60.0 weeks), and the median weight was 2,790 g (range: 1,580-4,100 g). Fifteen patients (33.3%) were positive for HD, which was confirmed after pull-through surgery. Ganglion cells were present in 30 patients. The diagnosis of HD was excluded in 29 patients after discharge follow-up. The sensitivity of SRB ranged from 93.7 to 100%, and the specificity was 100%. No complications occurred after SRB among the patients whose biopsy age was <37 weeks (10 patients) or biopsy weight was <2,000 g (five patients). SRB is accurate and safe for diagnosing HD in late preterm infants.
大多数小儿外科医生很少关注早产儿先天性巨结肠（HD）的诊断。我们旨在探讨经直肠吸引活检（SRB）诊断早产儿HD的安全性和准确性。对2015年至2019年在我院接受SRB的45例早产儿进行回顾性研究。我们收集了患者的临床特征、病理结果及随访信息，并计算了SRB诊断HD的敏感性和特异性。患者的中位胎龄为35周（范围：28.9 - 36.9周），活检时的中位胎龄为38.6周（范围：33.4 - 60.0周），中位体重为2790克（范围：1580 - 4100克）。15例（33.3%）患者HD阳性，经拖出式手术证实。30例患者存在神经节细胞。29例患者出院随访后排除HD诊断。SRB的敏感性为93.7%至100%，特异性为100%。活检年龄<37周的患者（10例）或活检体重<2000克的患者（5例）在SRB后均未发生并发症。SRB诊断晚期早产儿HD准确且安全。
