Guidelines for synoptic reporting of surgery and pathology in Hirschsprung disease

Veras, Laura V.; Arnold, Michael A.; Avansino, Jeffrey R.; Bove, Kevin E.; Cowles, Robert A.; Durham, Megan M.; Goldstein, Allan M.; Krishnan, Chandra; Langer, Jacob C.; Levitt, Marc A.; Monforte-Muñoz, Hector; Rabah, Raja; Reyes‐Múgica, Miguel; Rollins, Michael D.; Kapur, Raj P.; Gosain, Ankush

doi:10.1016/j.jpedsurg.2019.03.010

Cited by 39 publications

(27 citation statements)

References 15 publications

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“…In our series, we avoided three cases of a TZ pull-through by conducting a frozen section review of the donut and a further three likely could have been avoided. This guidance for frozen donut evaluation is also in keeping with the most recent recommendations from the APSA Hirschsprung Disease Interest Group [11].…”

Section: Discussionmentioning

confidence: 71%

Variability of the transition zone length in Hirschsprung disease

Thakkar

Blackburn

Curry

et al. 2020

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 71%

Variability of the transition zone length in Hirschsprung disease

Thakkar

Blackburn

Curry

et al. 2020

Journal of Pediatric Surgery

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“…These are minimal expectations. 57,58 Additional goals, arguably of more academic than clinical relevance, are to precisely define the length of the aganglionic segment and map the transition zone.…”

Section: Surgical Pathology Of the Pullthrough Resection Specimenmentioning

confidence: 99%

“…The American Pediatric Surgical Association HSCR Interest Group recently reported guidelines for surgical pathology reporting. 57 For resection specimens, elements deemed ''required'' included the type of pullthrough procedure, portion of colon resected, total length, length of mucosal sleeve (Soave only), positions of intraoperative biopsy sites, length of aganglionic segment, neuromuscular anatomy at the proximal surgical margin, and presence/ absence of active enterocolitis or skip areas. A synoptic template is available online (https://hematogones.com/ surg-path/hirsch), which uses dropdown menus to simplify data entry and format a surgical pathology report.…”

Section: Surgical Pathology Of the Pullthrough Resection Specimenmentioning

confidence: 99%

Surgery, Surgical Pathology, and Postoperative Management of Patients With Hirschsprung Disease

2019

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Endorectal pullthrough surgery is integral in the treatment of patients with Hirschsprung disease. Several different surgical procedures exist, which share as common goals to excise the aganglionic segment and upstream transition zone and attach ganglionic bowel just proximal to the anal canal. The operation requires collaboration between surgeon and pathologist to localize ganglionic bowel and prevent retention of transition zone. Intraoperative frozen sections are extremely important, first to establish that ganglion cells are present and subsequently to exclude features of transition zone (partial circumferential aganglionosis, myenteric hypoganglionosis, and submucosal nerve hypertrophy) at the proximal surgical (anastomotic) margin. Postoperative histopathological analysis of resection specimens should be tailored to document distal aganglionosis, document the length of the aganglionic segment and its proximity to the anastomotic margin, and confirm that transition zone has been resected completely. Adherence to the recommendations described in this review will reduce the likelihood of transition zone pullthrough and should decrease the incidence of persistent postoperative obstructive symptoms.

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“…Histological assessment is used to determine the required length of resection both pre and intra-operatively via frozen sections. In addition, post-operative assessment is required to ensure that the affected segment had been excised in its entirety 5 – 7 .…”

Section: Introductionmentioning

confidence: 99%

Automatic ganglion cell detection for improving the efficiency and accuracy of hirschprung disease diagnosis

Greenberg

Aizic

Зубков

et al. 2021

Sci Rep

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Histopathologic diagnosis of Hirschsprung's disease (HSCR) is time consuming and requires expertise. The use of artificial intelligence (AI) in digital pathology is actively researched and may improve the diagnosis of HSCR. The purpose of this research was to develop an algorithm capable of identifying ganglion cells in digital pathology slides and implement it as an assisting tool for the pathologist in the diagnosis of HSCR. Ninety five digital pathology slides were used for the construction and training of the algorithm. Fifty cases suspected for HSCR (727 slides) were used as a validation cohort. Image sets suspected to contain ganglion cells were chosen by the algorithm and then reviewed and scored by five pathologists, one HSCR expert and 4 non-experts. The algorithm was able to identify ganglion cells with 96% sensitivity and 99% specificity (in normal colon) as well as to correctly identify a case previously misdiagnosed as non-HSCR. The expert was able to achieve perfectly accurate diagnoses based solely on the images suggested by the algorithm, with over 95% time saved. Non-experts would require expert consultation in 20–58% of the cases to achieve similar results. The use of AI in the diagnosis of HSCR can greatly reduce the time and effort required for diagnosis and improve accuracy.

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Guidelines for synoptic reporting of surgery and pathology in Hirschsprung disease

Cited by 39 publications

References 15 publications

Variability of the transition zone length in Hirschsprung disease

Variability of the transition zone length in Hirschsprung disease

Surgery, Surgical Pathology, and Postoperative Management of Patients With Hirschsprung Disease

Automatic ganglion cell detection for improving the efficiency and accuracy of hirschprung disease diagnosis

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