RECTAL SUCTION BIOPSY LESS EFFECTIVE IN OLDER CHILDREN

Infographic · Feb 2023 · 1 min read

In brief

This comparative study of 258 rectal biopsy procedures found that suction biopsies had significantly higher inadequacy rates than incisional biopsies in children over 6 months old (24.1% vs 0.9%). The findings suggest incisional biopsy should be the preferred diagnostic method for Hirschsprung disease in older infants and children.

Rectal suction biopsy has 24.1% inadequacy rate vs 0.9% for incisional biopsy in children ≥6 months old (p<0.01)
Incisional rectal biopsy should be strongly considered as primary diagnostic method in patients older than 6 months
Both suction and incisional biopsies are appropriate for Hirschsprung diagnosis, but age affects suction biopsy adequacy
Study analyzed 133 suction procedures (227 biopsies) vs 125 incisional procedures (140 biopsies) at tertiary pediatric center

Written by the GCMD Library team from the infographic.

The infographic uses a red and white color scheme with three main panels. The left panel shows a colon diagram with an arrow indicating biopsy location. The center panel displays simplified human figures representing age groups (>6M and <6M) with a 'VS' between them. The right panel shows a microscope icon with a red X symbol and displays an odds ratio statistic.

Infographic by Chilenian Society of Pediatric Surgery

"Rectal suction biopsy versus incisional rectal biopsy in the diagnosis of Hirschsprung disease"

Authors: Nicole Green 1, Caitlin A Smith 2, Miranda C Bradford 3, Lusine Ambartsumyan 4, Raj P Kapur 5

Abstract

Background: Hirschsprung disease is one of the most common congenital anomalies that affect colorectal function. Rectal biopsy demonstrating the absence of ganglion cells in the affected bowel is the gold standard for diagnosis. Suction and incisional rectal biopsies are appropriate methods for obtaining diagnostic tissue. The goal of this study is to determine if any differences in adequacy exist between suction and incisional rectal biopsies at our institution.

Methods: We conducted a retrospective review of suction and incisional rectal biopsies for inadequacy per procedure at a tertiary pediatric hospital. Each procedure for rectal biopsy was also evaluated by a number of biopsies per procedure. We used a two-sample test of proportions to compare the inadequacy of suction vs. incisional biopsies.

Results: 133 rectal suction biopsy procedures (227 biopsies) and 125 incisional biopsy procedures (140 biopsies) were analyzed. In patients 6 months of age and older, the percentage of inadequate procedures was substantially higher in the suction biopsy group (24.1% vs 0.9%, p < 0.01).

Conclusions: A substantially higher proportion of inadequacy was found in the suction rectal biopsy group compared to the incisional cohort among the older patient cohort, suggesting incisional biopsies should be strongly considered as the primary rectal biopsy method in patients older than 6 months.

Keywords: Hirschsprung disease; Rectal biopsy.

The text in the image

RECTAL SUCTION BIOPSY LESS EFFECTIVE IN OLDER CHILDREN | SEATTLE USA | RETROSPECTIVE COHORT | 2000 - 2018 | HIRSCHSPRUNG DISEASE SUSPICION | TERTIARY HOSPITAL | n= 258 RECTAL BIOPSY PROCEDURES | (367 SAMPLES) | RECTAL SUCTION BIOPSY | >6M | <6M | VS | NON DIAGNOSTIC BIOPSY | OR 12.2 | (24.1% vs 2.9% | p<0.01) | Nicole Green et al, sep 2022. DOI: 10.1007/s00383-022-05246-4

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