{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:51:10Z","timestamp":1787500270937,"version":"build-2736575974"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>Introduction\u2003The U.K. National Institute for Health and Clinical Excellence (NICE) specify the following indications for performing rectal biopsy to rule out Hirschsprung's disease (HSD): (1) passage of meconium\u2009&gt;\u200948 hours; (2) constipation since first few weeks of life; (3) chronic abdominal distension with vomiting; (4) family history of HSD; and (5) faltering growth in addition to any other indication. The aim of this study was to assess the compliance of a tertiary referral center with the current U.K. NICE guidelines for performing rectal biopsies to rule out HSD. Secondary aims included assessing alternative indications and complication rates.<\/jats:p>\n                  <jats:p>Materials and Methods\u2003Retrospective analysis of patients undergoing open or suction rectal biopsies to investigate HSD, from 2009 to 2014.<\/jats:p>\n                  <jats:p>Results\u2003A total of 188 patients underwent 214 biopsies (suction: n\u2009=\u2009154, open: n\u2009=\u200960). Note that 128 patients (68.1%) had biopsies indicated by NICE. A total of 84.4% of indicated biopsies were ganglionic versus 91.7% of unindicated biopsies (p\u2009=\u20090.17). Twenty-five patients were diagnosed with HSD (mean age: 13.2 weeks, range: 3 days\u20133.2 years). Only 80% of HSD patients had NICE-indicated biopsies. Presentations for patients with biopsies not indicated by NICE included constipation, distension, and vomiting that did not strictly meet the guidelines. The majority of biopsies were uncomplicated (suction 82.5% vs. open 95.0%)\u2014inadequate\/indeterminate histology was the most common complication (16.2% suction vs. 5% open).<\/jats:p>\n                  <jats:p>Conclusion\u2003A significant number of unindicated biopsies were performed, the majority of which were ganglionic. Rectal biopsies are generally safe and strict adherence to the NICE guidelines could have led to missed HSD diagnoses with potential significant morbidity and mortality.<\/jats:p>","DOI":"10.1055\/s-0038-1675771","type":"journal-article","created":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T05:38:24Z","timestamp":1544506704000},"page":"097-101","source":"Crossref","is-referenced-by-count":12,"title":["Too Many Biopsies Performed to Rule Out Hirschsprung's Disease: But It is Worth Doing Them"],"prefix":"10.1055","volume":"29","author":[{"given":"Laura","family":"Phillips","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery, Noah's Ark Children's Hospital for Wales, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendra","family":"Surana","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery, Noah's Ark Children's Hospital for Wales, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Darwish","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Noah's Ark Children's Hospital for Wales, Cardiff, United Kingdom"},{"name":"Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,12,10]]},"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0038-1675771.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,1,17]],"date-time":"2019-01-17T18:37:47Z","timestamp":1547750267000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0038-1675771"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,10]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2019,1,17]]},"published-print":{"date-parts":[[2019,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0038-1675771","relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,10]]}}}