Ademaj Isber, Hyseni Nexhmi, Gjonbalaj Naser
Department of Pediatric Surgery, University Clinical Center of Kosovo, 10000 Pristina, Kosovo.
Department of Radiology, University Clinical Center of Kosovo, 10000 Pristina, Kosovo.
Pediatr Rep. 2024 Jun 25;16(3):542-550. doi: 10.3390/pediatric16030045.
Advancements in surgical management in a single-stage procedure made intraoperative frozen section biopsies critical for determining of level of resection to avoid the potential risk of leaving a retained aganglionic segment. However, in most low-income countries, due to the lack of this facility, the surgeon's intraoperative judgment is used for the determination of the resection level. This study aims to evaluate the accuracy of determining the level of bowel resection in short-segment Hirschsprung's disease based on macroscopic changes. Intraoperative macroscopic evaluations were assessed using postoperative microscopic findings to determine whether the surgeons' intraoperative judgments were accurate in determining the level of bowel resection in 60 cases of operated short-segment Hirschsprung's disease. In addition, Pearson's correlation coefficient was used to determine whether the sensitivity and specificity of both methods were significantly correlated. The microscopic results showed that the level of resection based on the macroscopic evaluation was performed in normally ganglionated segment in cases of short-segment Hirschsprung's disease. Macroscopic intraoperative assessment by an experienced surgeon is highly accurate method of determining the level of bowel resection in short-segment HSCR.
在单阶段手术的外科治疗进展中，术中冰冻切片活检对于确定切除水平至关重要，以避免留下残留无神经节段的潜在风险。然而，在大多数低收入国家，由于缺乏这种设施，外科医生的术中判断用于确定切除水平。本研究旨在评估基于宏观变化确定短段型先天性巨结肠症肠切除水平的准确性。使用术后显微镜检查结果评估术中宏观评估，以确定60例接受手术的短段型先天性巨结肠症患者中，外科医生在确定肠切除水平时的术中判断是否准确。此外，使用皮尔逊相关系数来确定两种方法的敏感性和特异性是否显著相关。显微镜检查结果表明，在短段型先天性巨结肠症病例中，基于宏观评估的切除水平是在正常神经节化段进行的。经验丰富的外科医生进行的术中宏观评估是确定短段型先天性巨结肠症肠切除水平的高度准确的方法。
