Correlation between the number of Interstitial cells of Cajal (ICC) and defecation pattern in patients with Hirschsprung's disease after Duhamel's surgery at General Hospital Dr. Soetomo

Abstract

Background: Hirschsprung is a congenital disorder of the distal bowel caused by the absence of a ganglion in the Aurbach and Meissner plexuses. Definitive treatment of the disorder is operative, namely by resection of the aganglionic segment of the intestine and performing a pull-through on the ganglionic segment. It cannot be denied that there are still disturbances in the pattern of defecation after definitive surgery, even though the pull-through segment has enough ganglion cells. Interstitial cells of Cajal (ICC) are the pacemaker in smooth muscle contraction in the intestine. In several studies, the number of these cells decreased in Hirschsprung's disease (HD), and it is not known with certainty the effect on the occurrence of defecation pattern disturbances. Methods: Data were collected retrospectively from all patients with Hirschsprung’s Disease (HD) who underwent Duhamel Procedure in Dr. Soetomo General Hospital, starting January 2016 – December 2021. Correlation analytic research with a cross sectional design was performed to analyze the correlation between the number of ICC and the defecation pattern of patients at Dr. Soetomo after Duhamel surgery. Results: From this study, it was found a decrease in the number of ICC in the ganglionic segments of the resected specimens from pull-through surgery. From the results of the correlation test, it was found that the p-value was 0.49 for the defecation pattern of postoperative Duhamel patients at Dr. Soetomo for the period January 2016 – December 2021. Conclusion: In this study, a significant correlation was found between the number of ICC and definitive pull-through postoperative defecation pattern.