Guidelines for synoptic reporting of surgery and pathology in Hirschsprung disease

Laura V Veras; Michael Arnold; Jeffrey R Avansino; Kevin Bove; Robert A Cowles; Megan M Durham; Allan M Goldstein; Chandra Krishnan; Jacob C Langer; Marc Levitt; Hector Monforte-Munoz; Raja Rabah; Miguel Reyes-Mugica; Michael D Rollins 2nd; Raj P Kapur; Ankush Gosain; American Pediatric Surgical Association Hirschsprung Disease Interest Group

doi:10.1016/j.jpedsurg.2019.03.010

Guidelines for synoptic reporting of surgery and pathology in Hirschsprung disease

J Pediatr Surg. 2019 Oct;54(10):2017-2023. doi: 10.1016/j.jpedsurg.2019.03.010. Epub 2019 Mar 21.

Authors

Laura V Veras¹, Michael Arnold², Jeffrey R Avansino³, Kevin Bove⁴, Robert A Cowles⁵, Megan M Durham⁶, Allan M Goldstein⁷, Chandra Krishnan⁸, Jacob C Langer⁹, Marc Levitt¹⁰, Hector Monforte-Munoz¹¹, Raja Rabah¹², Miguel Reyes-Mugica¹³, Michael D Rollins 2nd¹⁴, Raj P Kapur¹⁵, Ankush Gosain¹⁶; American Pediatric Surgical Association Hirschsprung Disease Interest Group

Affiliations

¹ Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center; Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA.
² Ohio State University, Pathology and Laboratory Medicine, Nationwide Children's, Columbus, OH, USA.
³ University of Washington, Department of Surgery, Division of Pediatric Surgery, Seattle Children's Hospital, Seattle, WA, USA.
⁴ University of Cincinnati, Department of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
⁵ Section of Pediatric Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
⁶ Emory University Department of Surgery, Division of Pediatric Surgery; Children's Healthcare of Atlanta, Atlanta, GA, USA.
⁷ Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁸ Clinical Pathology Associates, Dell Children's Medical Center of Central Texas, Austin, TX, USA.
⁹ Division of Pediatric General and Thoracic Surgery, Hospital for Sick Children, and Department of Surgery, University of Toronto, Toronto, Canada.
¹⁰ Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
¹¹ Anatomic Pathology, Johns Hopkins All Children's Hospital, Saint Petersburg, FL, USA.
¹² University of Michigan, Department of Pathology, C.S. Mott Children's Hospital, Ann Arbor, MI, USA.
¹³ University of Pittsburgh, Department of Pathology, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
¹⁴ University of Utah, Department of Surgery, Division of Pediatric Surgery, Primary Children's Hospital, Salt Lake City, UT, USA.
¹⁵ Department of Laboratories, Seattle Children's Hospital, University of Washington, Seattle, WA, USA. Electronic address: [email protected].
¹⁶ Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center; Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA. Electronic address: [email protected].

Abstract

Background/purpose: Synoptic, or standardized, reporting of surgery and pathology reports has been widely adopted in surgical oncology. Patients with Hirschsprung disease may experience morbidity related to surgical factors or underlying pathology and often undergo multiple operations. Our aim is to improve the postoperative outcome and care of patients with Hirschsprung disease by proposing a standardized set of data that should be included in every surgery and pathology report.

Methods: Members of the American Pediatric Surgical Association Hirschsprung Disease Interest Group and experts in pediatric pathology of Hirschsprung disease participated in group discussions, performed literature review and arrived at expert consensus guidelines for surgery and pathology reporting.

Results: The importance of accurate operative and pathologic reports and the implications of inadequate documentation in patients with Hirschsprung disease are discussed and guidelines for standardizing these reports are provided.

Conclusions: Adherence to the principles of reporting for operations and surgical pathology may improve outcomes for Hirschsprung disease patients and will facilitate identification of correlations among morphology, function, genetics and outcomes, which are required to improve the overall management of these patients.

Level of evidence: V.

Keywords: Aganglionosis; Enteric nervous system; Hirschsprung disease; Pathology; Surgery; Synoptic.

Publication types

Review

MeSH terms

Digestive System Surgical Procedures / methods*
Enteric Nervous System / pathology*
Hirschsprung Disease / pathology
Hirschsprung Disease / surgery*
Humans
Practice Guidelines as Topic*

Abstract

Publication types

MeSH terms

Grants and funding