The Immunohistochemical Staining in Determination of Postoperative Bowel Dysfunction in Children with Hirschsprung's Disease

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Resident, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Assistant Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The aim of this study was to evaluate the calretinin and nitric oxide (NO) immunohistochemical (IHC) staining in ganglionic segment of colon of children with Hirschsprung's disease (HD).Methods: In a cross-sectional study, 60 children with HD entered the study, and underwent surgery to pull out the bowel from the anus to take biopsy from every 5 cm. Hematoxylin and eosin (H&E) and IHC methods were evaluated, and the results were reported to be poorly positive or severely positive for calretinin. All patients were followed up 1 and 6 months after the operation, and the results were compared between the two groups.Findings: From 60 children with HD, 14 patients (23.3%) were symptomatic. In 14 symptomatic patients, all colorectal samples from ganglionic segments were negative for NO staining in comparison of placental NO staining as sham group. In the IHC examination, nuclear and cytoplasmic calretinin staining revealed ganglion cells in 52 patients as strongly positive, and weakly positive in 8 patients. Six patients in strongly positive group (11.5%) were symptomatic, while 8 patients whose calretinin staining was reported as weakly stained, had symptoms (P = 0.001). Overall accuracy of prediction of postoperative constipation for calretinin staining was 96.67%.Conclusion: According to the findings of our study, it seems that in children with HD who undergo surgery, proximal ganglion immunohistochemical staining may be effective in determining postoperative bowel dysfunction.

Keywords

References

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Journal of Isfahan Medical School
Volume 38, Issue 587 - Serial Number 587
July and August 2020
Pages 582-588

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History

  • Receive Date: 28 February 2020
  • Revise Date: 22 May 2024
  • Accept Date: 06 April 2022

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