Schmittenbecher P P, Schmidt A, Meier-Ruge W, Wiebecke B
Department of Pediatric Surgery, Dr. von Hauner's Childrens Hospital, University of Munich, Germany.
Eur J Pediatr Surg. 1995 Oct;5(5):277-9. doi: 10.1055/s-2008-1066224.
Rectal suction biopsy is the diagnostic procedure of choice in aganglionosis even if only mucosal tissue is obtained. In neuronal intestinal dysplasia it is essential to include parts of the submucous layer. Therefore some biopsies are unsuitable because they lack submucous tissue. In a retrospective analysis (1991-1993) this occurred in 34.9% of our biopsies. These samples were taken without attention to the level of suction. Prospectively we compared suction biopsies taken by a standard suction level (250-300 cm water column) with excision biopsies taken by scissors under speculum exposure in ten consecutive patients. Submucosa was missed in only one biopsy each, but two excision biopsies were made useless by mechanical traumatization. We conclude a correctly practised rectal suction biopsy still remains the procedure of choice for diagnostic screening in malformations of the enteric nervous system.
即使仅获取到黏膜组织，直肠吸引活检仍是先天性巨结肠症的首选诊断方法。对于神经源性肠发育异常，获取黏膜下层组织至关重要。因此，一些活检样本不合适，因为它们缺乏黏膜下层组织。在一项回顾性分析（1991 - 1993年）中，我们的活检样本中有34.9%出现这种情况。这些样本采集时未注意吸引水平。前瞻性地，我们将10例连续患者中按照标准吸引水平（250 - 300厘米水柱）进行的吸引活检与在窥镜暴露下用剪刀进行的切除活检进行了比较。每种活检方式各仅有1例未获取到黏膜下层组织，但有2例切除活检因机械损伤而无法使用。我们得出结论，正确实施的直肠吸引活检仍然是肠道神经系统畸形诊断筛查的首选方法。
