Diagnostic value of Rectal Biopsy in Children with Chronic Idiopathic Constipation

Bibliographic InformationReason for rejecting study
Santos et al. Study of acetylcholinesterase activity in rectal suction biopsy for diagnosis of intestinal dysganglionoses: 17-Year experience of a single center. 2008. Pediatric Surgery International 24[6], 715-719Germany.Clinical data poorly reported
Montedonico et al. Histochemical staining of rectal suction biopsies as the first investigation in patients with chronic constipation. 2008. Pediatric Surgery International 24[7], 785-792Clinical data poorly reported
Nofech-Mozes et al. Difficulties in making the diagnosis of Hirschsprung disease in early infancy. 2004. Journal of Paediatrics and Child Health 40[12], 716-719Australia.Small sample size, weak study design: 3 case studies
Polley et al. Suction rectal biopsy in the diagnosis of Hirschsprung's disease and chronic constipation. 1986. Pediatric Surgery International 1[2], 84-89Germany.No clinical data
Iwai et al. Reliability of anorectal manometry in the diagnosis of Hirschsprung's disease. 1988. Zeitschrift fur Kinderchirurgie 43[6], 405-407Study on anorectal manometry, no useful data on rectal biopsy
Tomita et al. Histological studies on Hirschsprung's disease and its allied disorders in childhood. 2004. Hepato-gastroenterology 51[58], 1042-1044No clinical data
Simpson et al. Surgical evaluation and management of refractory constipation in older children. 1996. Journal of Pediatric Surgery 31[8], 1040-1042Clinical data poorly reported. No analysis of correlation between clinical data and histological diagnosis
Mishalany et al. Chronic constipation. Manometric patterns and surgical considerations. 1984. Archives of Surgery 119[11], 1257-1259Scant clinical data. No comparison made between groups. 80 patients: 3 segmental dilatation of colon, 4 Hirschsprung's disease, 73 with radiologically dilated anorectum + impaction, but 49 biopsies all normal in the latter group
Ikawa et al. Acetylcholinesterase and manometry in the diagnosis of the constipated child. 1986. Archives of Surgery 121[4], 435-438No clinical data
MacMahon et al. Hirschsprung-like syndromes in patients with normal ganglion cells on suction rectal biopsy. 1981. Journal of Pediatric Surgery 16[6], 835-839Small sample size, weak study design: 3 case studies
Anupama et al. Ten-year experience in the management of total colonic aganglionosis. 2007. Journal of Pediatric Surgery 42[10], 1671-1676United States.Case series, no comparison group. Population not relevant to the guideline: 25 children with total colonic aganglionosis chosen from a series of 831 children with Hirschsprung's disease
Ito et al. Maturation of the rectoanal response in premature and perinatal infants. 1977. Journal of Pediatric Surgery 12[3], 477-482No clinical data
Bonham et al. A 7-year study of the diagnostic value of rectal mucosal acetylcholinesterase measurement in Hirschsprung's disease. 1987. Journal of Pediatric Surgery 22[2], 150-152United States.Scant clinical data
Weintraub et al. A simplified approach to diagnostic rectal biopsy in infants and children. 1977. American Journal of Surgery 134[2], 307-310Clinical data poorly reported
Kurer et al. Suction biopsy in Hirschsprung's disease. 1986. Archives of Disease in Childhood 61[1], 83-84United Kingdom.No clinical data
Momoh. Short-segment Hirschsprung's disease. 1988. Tropical Doctor 18[1], 16-19United Kingdom.Histological findings not reported in correlation with clinical variables
Bagdzevicius et al. Experience of acetylcholinesterase histochemistry application in the diagnosis of chronic constipation in children. 2007. Medicina 43[5], 376-384Clinical data poorly reported
Wheatley et al. Hirschsprung's disease in adolescents and adults. 1990. Diseases of the Colon and Rectum 33[7], 622-6295 case studies: 2 adolescents and 3 adults
Barr et al. Clinical evaluation of the histochemical diagnosis of Hirschsprung's disease. 1985. Gut 26[4], 393-399Not possible to establish correlation between clinical presentation and histological findings
Low et al. Accuracy of anorectal manometry in the diagnosis of Hirschsprung's disease. 1989. Journal of Pediatric Gastroenterology and Nutrition 9[3], 342-34645 patients had concordant results (both on manometry and biopsy) and only those were included in the analysis for clinical features, but it is unclear why. 4 patients with rectal biopsies showing aganglionosis but negative manometry were excluded, considering rectal biopsy is the gold standard to diagnose HD this introduces bias in the study.
Wendelschafer-Crabb et al. Mucosal nerve deficiency in chronic childhood constipation: a postmigration defect? 2009. Journal of Pediatric Surgery 44[4], 773-782United States.No clinical data reported
Yadav et al. Hirschsprung's disease: is there a relationship between mast cells and nerve fibers? 2009. World Journal of Gastroenterology 15[12], 1493-1498No clinical data reported

From: Appendix K, Excluded studies

Cover of Constipation in Children and Young People
Constipation in Children and Young People: Diagnosis and Management of Idiopathic Childhood Constipation in Primary and Secondary Care.
NICE Clinical Guidelines, No. 99.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2010.
Copyright © 2010, National Collaborating Centre for Women's and Children's Health.

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