Comparing the Frozen Section and Permanent Section of Hirschsprung's Disease in One Staged Surgery

Hirschsprung's disease (HD) is a relatively common problem among children and may be in differential diagnosis with many other diseases and even physiological conditions or functional abnormalities. Therefore, proper diagnosis is very important. On the other hand, determining the true agangliosis level is vital; because the wrong estimation would lead to inadequate or excessive resection. Determination of the level of agangliosis in HD is achieved by intraoperative examination of obtained frozen sections. This study aimed at comparing the frozen section and permanent section of HD in one staged surgery. Forty patients with definitely diagnosed HD were operated by Transanal one-stage endorectal pull-through (TOSEPT) approach. Intraoperative biopsies were performed from the most distal portion suspected to have no ganglions and extended toward the transitional zone and several frozen sections were evaluated pathologically. After operation was completed, the result of permanent sections in each patient was compared with those of frozen section study. The mean concordance rate of results in frozen section and permanent section studies was 98.17±1.60%; 100% in 36 cases, 83.3% in 2 cases, and 80% in 2 cases. The concordance rate was 100% in the first and the last samples. The reported discrepancies were as follows: in the 5th sample out of 6; “few" was reported in the frozen section but " some" was reported in permanent section. In the 4th sample out 5; "a few" and "some" was reported in frozen and permanent sections, respectively. This study showed that there is a high concordance between the results of frozen section study and permanent section in patients with HD. Therefore, permanent section can be replaeed by the frozen section studies