Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany.
Neurological Institute (Edinger Institute), University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
Pediatr Dev Pathol. 2023 May-Jun;26(3):287-291. doi: 10.1177/10935266231162684. Epub 2023 Mar 30.
Hirschsprung disease (HD) is an aganglionosis of variable length starting at the rectosigmoid colon with surgery as sole therapeutic option. The length of the resected bowel segment is a crucial information for the treating surgeons and influences the prognosis of the patient. It is often artificially altered due to post operative tissue shrinkage. The objective of this study is to quantify the extent tissue shrinkage of HD specimens.
Colorectal HD specimens were measured at the time of surgery and at the time of cut-up, either fresh or after formalin fixation and statistically analyzed.
Sixteen colorectal specimens were included. Following formalin fixation the specimen length decreased by 22.7% ( < .001). Without formalin fixation the specimens shrank by an average of 24.9% ( = .05). There was no significant difference in the extent of tissue shrinkage with or without formalin fixation ( = .76).
This study showed that there is significant tissue shrinkage in HD specimens. The 2 different cohorts revealed that tissue shrinkage is mostly caused by tissue retraction/alteration after organ removal but also to a lesser extent by fixation with formalin. Surgeons and (neuro-)pathologists should be aware of the sizeable shrinking artifact to avoid unnecessary confusion.
先天性巨结肠（HD）是一种以直肠乙状结肠为起始点的不定长无神经节细胞症，手术是唯一的治疗选择。切除肠段的长度是治疗外科医生的关键信息，会影响患者的预后。由于术后组织收缩，该长度通常会被人为改变。本研究旨在定量测量 HD 标本的组织收缩程度。
在手术时和切割时测量肛肠 HD 标本，新鲜标本或福尔马林固定后标本均进行测量，并进行统计学分析。
共纳入 16 例肛肠标本。福尔马林固定后标本长度减少 22.7%（ < .001）。未经福尔马林固定时，标本平均收缩 24.9%（ = .05）。福尔马林固定与不固定时组织收缩程度无显著差异（ = .76）。
本研究表明 HD 标本存在显著的组织收缩。这 2 个不同队列的研究表明，组织收缩主要是由于器官切除后组织回缩/改变引起的，但在较小程度上也与福尔马林固定有关。外科医生和（神经）病理学家应该意识到这种显著的收缩伪影，以避免不必要的混淆。
