The Distribution Of Intestinal Nerve And Smooth Muscle Cells Layers In The Resected Bowel From Human Hirschsprung's Disease And Their Clinical Significance

Objective: Through evaluating the histopathological alterations of enteric ganglion cells nerve fiber and smooth muscle cells in the resected whole bowel specimens from patients with Hirschsprung' s disease (HD) ,this study was to discuss the mechanism of postoperative dysmotility in HD,and to explore resected lengths of whole bowel from HD patients in radical operation. Methods: Forty cases of HD were studied .Specimens were taken from the resected whole bowel segments of HD. [short type and recto-sigmoid type (n=32),long type(n=8)].Nine controls were obtained from postmortem neonates without gastro-intestinal or neuroal Synstem dieases.All specimens were stained with haematoxylin and eosin (HE) to count the number of ganglion cells in Auerbach plexus(AP) under light microscope .In addition ,all specimens were processed for SP immunhistochmistry by using different monoclonal antibody , including Synaptophsion ( Syn ) protein and neural cell adhesion molecule(NCAM),then the levels of expression were semiquantitated respectively. Results: Reduction of AP,ganglionic cell and intramuscular nerve fibers were observed in distal segments of HD.Changes of AP and ganglionic cell extended all longth of resected segments,but showed a tendency on the incresse at the farther of aganglionic segments.Little changes was observed in proximal segments of HD.Firstly,absence of ganglion cell and present of abnormal hypertrophic fiber trunks in AP were seen in aganglionic segments.At transitional segments, immature ganglion cells and reduction of abnormal hypertrophic fiber trunks showed in AP .The number of ganglion cells and intramuscular nerve fibers became normal at 8cm from transitional segments in this study(P>0.05).