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Comparison of inconclusive rates between suction rectal biopsy and open strip rectal biopsy in children of different age groups: a single-center retrospective study
  1. Cedric Ian Ng Liet Hing,
  2. Roy Teng,
  3. Liesel Porrett and
  4. Richard Thompson
  1. Paediatric Surgery, Gold Coast University Hospital, Southport, Queensland, Australia
  1. Correspondence to Dr Cedric Ian Ng Liet Hing; ced_nlh{at}


Background Rectal biopsy for the diagnosis for Hirschsprung's disease (HD) can be performed in several ways. Suction rectal biopsy (SRB) is the most widely used method for neonates and younger infants while open strip biopsy (OSB) is reserved for older children. Current notions suggest that SRB should not be used in older infants due to perceived thicker fibrous tissue in their rectal walls leading to higher rates of inconclusive results. This study aims to compare the inconclusive rates of both methods in children of different age groups.

Methods A retrospective study were carried out with patients aged 13 years who underwent SRB or OSB during a 4-year period in a single center. Rectal biopsies were performed on patients with HD with previous endorectal pull-through surgeries excluded. Primary outcomes were rates of inconclusive results for SRB and OSB overall and when divided into different age groups.

Results 79 biopsies (57 SRB and 22 OSB) were included in the study. 12 biopsies (9 SRB and 3 OSB) were deemed inconclusive. There was no significant difference in the rate of inconclusive results between patients underwent SRB and OSB overall (15.8% vs 13.6%, p=1.000). The same results were obtained when patients were divided into under one year and over one year groups or other different age groups (30.0% vs 33.3%, p=1.000).

Conclusions Despite low biopsy numbers, our study suggests that SRB provides comparable rates of inconclusive results with OSB in children of all age groups.

  • gastroenterology
  • paediatric surgery

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  • Contributors RoT and LP devised the project, the main conceptual ideas and proof outline. CINLH and RT collected the data, performed the data analysis and wrote the draft. RiT supervised and directed the project.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The project was acknowledged by the Gold Coast Hospital and Health Service Human Research Ethics Committee (HREC) as a low and negligible risk project undertaken in an ethical manner. LNR/2019/QGC/54346.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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