{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T02:52:28Z","timestamp":1789267948852,"version":"build-2803163510"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>The aim of this study was to review the use of the on-table \u201cdoughnut\u201d biopsy for frozen section assessment of bowel in the operative management of Hirschsprung's disease (HD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a single-center retrospective review of doughnut histopathology reports, operation notes, and slides from 2010 to 2017. Data were assessed for the presence of transition zone (TZ) features and the subsequent decision as to the level of pull-through.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Fifty-five patients had a doughnut biopsy taken as part of their intraoperative frozen section histopathology for pull-through for HD during the study period. Forty-eight required a single doughnut, six required a second more proximal doughnut, and one required a third doughnut. Of the 55 first doughnuts, 37 were identified as normal bowel, 17 were TZ, and not defined in the report in one case. Of the 17 TZ doughnuts, 8 were accepted for pull-through and 7 underwent second doughnuts (normal = 4 and TZ = 3). The third doughnut (one case) was normal. TZ was accepted for pull-through in 10\/54 (18.5%) patients despite the use of a doughnut. However, TZ was avoided in six (11.1%), where the single-point biopsy was \u201cnormal.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The doughnut allows the entire circumference of pull-through level to be assessed, enabling TZ identification that can be missed by single seromuscular biopsies. This allows identification and avoidance of TZ pull-through, although sometimes, it is accepted for other reasons.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_43_20","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T13:12:59Z","timestamp":1614949979000},"page":"111-116","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Routine use of Circumferential \u2018Doughnut\u2019 Biopsy in Pull through Surgery for Hirschsprung's Disease"],"prefix":"10.4103","volume":"26","author":[{"given":"Govind V. S.","family":"Murthi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver G.","family":"Townley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard M","family":"Lindley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta C.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-9-20240905","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/s100249910028","article-title":"Circumferential distribution of ganglion cells in the transition zone of children with Hirschsprung disease","volume":"3","author":"White","year":"2000","journal-title":"Pediatr Dev Pathol"},{"key":"R2-9-20240905","first-page":"520","article-title":"Pathology of the ganglionic-aganglionic junction in congenital megacolon","volume":"69","author":"Gherardi","year":"1960","journal-title":"Arch Pathol"},{"key":"R3-9-20240905","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1053\/j.sempedsurg.2012.07.003","article-title":"Transitional zone pull-through: Surgical pathology considerations","volume":"21","author":"Kapur","year":"2012","journal-title":"Semin Pediatr Surg"},{"key":"R4-9-20240905","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1016\/j.jpedsurg.2019.04.017","article-title":"The extent of the transition zone in Hirschsprung disease","volume":"54","author":"Coyle","year":"2019","journal-title":"J Pediatr Surg"},{"key":"R5-9-20240905","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1053\/jpsu.2000.19263","article-title":"Hirschsprung's disease: Problems with transition-zone pull-through","volume":"35","author":"Ghose","year":"2000","journal-title":"J Pediatr Surg"},{"key":"R6-9-20240905","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1007\/s00383-011-2958-5","article-title":"Residual aganglionosis after pull-through operation for Hirschsprung's disease: A systematic review and meta-analysis","volume":"27","author":"Friedmacher","year":"2011","journal-title":"Pediatr Surg Int"},{"key":"R7-9-20240905","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1111\/ans.13745","article-title":"Transition zone pull-through in Hirschsprung's disease: A tertiary hospital experience","volume":"87","author":"Ghosh","year":"2017","journal-title":"ANZ J Surg"},{"key":"R8-9-20240905","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/S0022-3468(96)90751-4","article-title":"The structure of the transitional and aganglionic zones of Auerbach's plexus in patients with Hirschsprung's disease: A computer-assisted three-dimensional reconstruction study","volume":"31","author":"Miura","year":"1996","journal-title":"J Pediatr Surg"},{"key":"R9-9-20240905","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/j.jpedsurg.2004.05.009","article-title":"Reliability of intraoperative frozen sections in the management of Hirschsprung's disease","volume":"39","author":"Shayan","year":"2004","journal-title":"J Pediatr Surg"},{"key":"R10-9-20240905","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.humpath.2009.12.012","article-title":"Counting myenteric ganglion cells in histologic sections: An empirical approach","volume":"41","author":"Swaminathan","year":"2010","journal-title":"Hum Pathol"},{"key":"R11-9-20240905","doi-asserted-by":"crossref","first-page":"252","DOI":"10.2350\/12-12-1282-OA.1","article-title":"Histopathologic delineation of the transition zone in short-segment Hirschsprung disease","volume":"16","author":"Kapur","year":"2013","journal-title":"Pediatr Dev Pathol"},{"key":"R12-9-20240905","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1097\/PAS.0000000000000711","article-title":"Histology of the transition zone in hirschsprung disease","volume":"40","author":"Kapur","year":"2016","journal-title":"Am J Surg Pathol"}],"container-title":["Journal of Indian Association of Pediatric Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.JIAPS_43_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:20:11Z","timestamp":1787844011000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.JIAPS_43_20"}},"subtitle":["Advantages and Limitations"],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/jiaps.jiaps_43_20","relation":{},"ISSN":["0971-9261"],"issn-type":[{"value":"0971-9261","type":"print"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}