{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T03:24:50Z","timestamp":1780370690419,"version":"3.54.1"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T00:00:00Z","timestamp":1582588800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T00:00:00Z","timestamp":1582588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012521","name":"Universitas Gadjah Mada","doi-asserted-by":"publisher","award":["RTA #3128\/UN1\/DITLIT\/DIT-LIT\/LT\/2019"],"award-info":[{"award-number":["RTA #3128\/UN1\/DITLIT\/DIT-LIT\/LT\/2019"]}],"id":[{"id":"10.13039\/501100012521","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Res Notes"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>While frozen section methods have been widely conducted to determine aganglionosis segment during transanal endorectal pull-through (TEPT) for Hirschsprung disease (HSCR) patients in most institutions, some hospitals still rely on contrast enema to predict aganglionosis segments due to unavailability of frozen section facilities. We determined the accuracy of transition zone in contrast enema to predict aganglionosis segments during TEPT. We retrospectively reviewed all contrast enema and frozen sections for HSCR patients under 2\u00a0years of age who underwent TEPT at our institution.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>We recruited 36 HSCR patients: twenty-six patients (72.2%) had radiographic transition zones limited to rectum, while ten subjects (27.8%) were limited to rectosigmoid. The rectum subgroup of patients showed a concordance of 30.8%, whereas the rectosigmoid subgroup had a concordance of 100%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of contrast enema compared with intraoperative histopathological findings for aganglionosis level were 100% (95% CI 0.60\u20131.0), 35.7% (95% CI 0.19\u20130.56), 30.8% (95% CI 0.15\u20130.52), 100% (95% CI 0.66\u20131.0), and 50% (95% CI 0.33\u20130.67), respectively. In conclusions, contrast enema has low accuracy to predict intraoperative aganglionosis segments in HSCR patients, indicating that it might not be utilized to determine aganglionosis level during TEPT.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s13104-020-04945-2","type":"journal-article","created":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T16:02:42Z","timestamp":1582646562000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Accuracy of transition zone in contrast enema to predict intraoperative aganglionosis level in patients with Hirschsprung disease"],"prefix":"10.1186","volume":"13","author":[{"given":"Zikrul","family":"Haikal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andi","family":"Dwihantoro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesti","family":"Gunarti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4707-6526","authenticated-orcid":false,"family":"Gunadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,25]]},"reference":[{"key":"4945_CR1","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1007\/s00383-015-3730-z","volume":"31","author":"D Mc Laughlin","year":"2015","unstructured":"Mc Laughlin D, Puri P. Familial Hirschsprung\u2019s disease: a systematic review. Pediatr Surg Int. 2015;31:695\u2013700.","journal-title":"Pediatr Surg Int"},{"key":"4945_CR2","volume-title":"Pediatric Surgery","author":"JC Langer","year":"2012","unstructured":"Langer JC. Hirschsprung Disease. In: Coran AG, Adzick NS, Krummel TM, et al., editors. Pediatric Surgery. 7th ed. Philadelphia: Elsevier; 2012.","edition":"7"},{"key":"4945_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/jmg.2007.053959","volume":"45","author":"J Amiel","year":"2008","unstructured":"Amiel J, Sproat-Emison E, Garcia-Barcelo M, et al. Hirschsprung disease, associated syndromes and genetics: a review. J Med Genet. 2008;45:1\u201314.","journal-title":"J Med Genet"},{"key":"4945_CR4","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1186\/s13104-018-3751-5","volume":"11","author":"Gunadi","year":"2018","unstructured":"Gunadi, Karina SM, Dwihantoro A. Outcomes in patients with Hirschsprung disease following definitive surgery. BMC Res Notes. 2018;11:644.","journal-title":"BMC Res Notes"},{"key":"4945_CR5","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.jss.2018.07.067","volume":"233","author":"Gunadi","year":"2019","unstructured":"Gunadi, Iskandar K, Makhmudi A, Kapoor A. Combined genetic effects of RET and NRG1 susceptibility variants on multifactorial Hirschsprung disease in Indonesia. J Surg Res. 2019;233:96\u20139.","journal-title":"J Surg Res"},{"key":"4945_CR6","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1053\/j.sempedsurg.2009.11.016","volume":"19","author":"L De La Torre","year":"2010","unstructured":"De La Torre L, Langer JC. Transanal endorectal pull-through for Hirschsprung disease: technique, controversies, pearls, pitfalls, and an organized approach to the management of postoperative obstructive symptoms. Semin Pediatr Surg. 2010;19:96\u2013106.","journal-title":"Semin Pediatr Surg"},{"key":"4945_CR7","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1007\/s00383-017-4064-9","volume":"33","author":"X Chen","year":"2017","unstructured":"Chen X, Xiaojuan W, Zhang H, Jiao C, Yu K, Zhu T, Feng J. Diagnostic value of the preoperatively detected radiological transition zone in Hirschsprung\u2019s disease. Pediatr Surg Int. 2017;33:581\u20136.","journal-title":"Pediatr Surg Int"},{"key":"4945_CR8","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1007\/s00383-012-3094-6","volume":"28","author":"CO Muller","year":"2012","unstructured":"Muller CO, Mignot C, Belarbi N, Berrebi D, Bonnard A. Does the radiographic transition zone correlate with the level of aganglionosis on the specimen in Hirschsprung\u2019s disease? Pediatr Surg Int. 2012;28:597\u2013601.","journal-title":"Pediatr Surg Int"},{"key":"4945_CR9","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1016\/jpsu.2003.50165","volume":"38","author":"ML Proctor","year":"2003","unstructured":"Proctor ML, Traubici J, Langer JC, Gibbs DL, Ein SH, Daneman A, et al. Correlation between radiographic transition zone and level of aganglionosis in Hirschsprung\u2019s disease: implications for surgical approach. J Pediatr Surg. 2003;38:775\u20138.","journal-title":"J Pediatr Surg"},{"key":"4945_CR10","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1007\/s00247-004-1292-7","volume":"34","author":"DH Jamieson","year":"2004","unstructured":"Jamieson DH, Dundas SE, Belushi SA, Cooper M, Blair GK. Does the transition zone reliably delineate aganglionic bowel in Hirschsprung\u2019s disease? Pediatr Radiol. 2004;34:811\u20135.","journal-title":"Pediatr Radiol"},{"key":"4945_CR11","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/s12893-017-0267-1","volume":"17","author":"JA Setiadi","year":"2017","unstructured":"Setiadi JA, Dwihantoro A, Iskandar K, Heriyanto DS, Gunadi. The utility of the hematoxylin and eosin staining in patients with suspected Hirschsprung disease. BMC Surg. 2017;17:71.","journal-title":"BMC Surg"},{"key":"4945_CR12","first-page":"53","volume":"23","author":"R Granero Cend\u00f3n","year":"2010","unstructured":"Granero Cend\u00f3n R, Moya Jim\u00e9nez MJ, Cabrera Garc\u00eda R, Tuduri Limousin I, Hern\u00e1ndez Orgaz A, De Agust\u00edn Asensio JC, et al. Relationship between the radiographic length of the opaque enema and the aganglionic length of the segment in Hirschsprung\u2019s disease (abstract). Cir Pediatr. 2010;23:53\u20136.","journal-title":"Cir Pediatr"},{"key":"4945_CR13","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1002\/ca.22941","volume":"30","author":"SA Mirjalili","year":"2017","unstructured":"Mirjalili SA, Tarr G, Stringer M. The length of the large intestine in children determined by computed tomography scan. 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