The Relationship Between Interstitial Cells Of Cajal,nNOS Nerves And HD With Postoperative Enterocolitis

Objective:The current study is to investigate the role of ICC and nNOS in the pathogenesis of HD through observing the distribution of the two types of cells in HD's different segments。To assess the relationship between the post-operative complication and interstitial cells of Cajal in Hirschsprung's disease through investigating complication and associated defecation after operation in HD。Investigates the role of ICC and the nNOS in the pathogenesis of Hirschsprung's disease and postoperative complications。Methods:The aganglionic ,transitional and dilated segments were collected in operation from 40 children with Hirschsprung's disease in Jiangxi Chindren Hospital。Another 4 normal segmengts were also collected without gastrointestinal or neuroal system diseases。Each case was confirmed common HD with pathological report after operation。Each sections was stained by HE and nNOS,C-kit immunohisto-chemistry approach。The distribution of the ganglionic cells and the interstitial cells of Cajal was observed by light microscope。To investigate the post-operative complication and defecation of each case,and score according to li's。To assess the relationship between the post-operative complication,nNOS and interstitial cells of Cajal in Hirschsprung's disease。Results:In the normal colon,ICC were mainly located in the interspace between the circular muscle layer and the submucosal border;within the circular and longitudinal muscle layers and associated with myenteric nerve plexus,which were called as ICC-SM, ICC-CM,ICC-LM and ICC-IM;Moreover,wholemount preparations showed that,not only the number of ICC-IM was decreased down,but also the processes of ICC-IM presented fewer branches and the cellular network was broken down;However,the nNOS ganglionic cells and ICC in aganglionic segments of colon from Hirchsprung's disease were decreased significantly and statistically than that in dilated segments and in normal colon。The nNOS ganglionic cells and ICC in dilated segments were not conspicuous difference than in normal colon。Thirty patients were followed-up,six of them were subjected to enterocolitis (EC)。There was no relationship between the age and sex。we founded that the cajal in dilated segments were decreased significantly in the six patients than in not subjected to EC. The cellular network of ICC in the six patients was broken down。The excellent results,as defined by Li's score,anorectal function was 73.3%。We founded that anorectal function was significant difference between subjected to EC and not。Conclusions:1,The abnormal distribution of ICC in dilated segment may be damaged by the defect of Embryo matrix。The defect of Embryo matrix not only damage the migration of neural crest cell,but also the differentiation and maturation of ICC。2,The abnormal distribution of ICC in dilated segment should be according to the EC。Complete resection of abnormal distribution of ICC in dilated segment may minimize the incidence of postoperative EC。...