The Clinical Significance Of Pathological Studies Of Ongenital Intestinal Atresia

Objective: The purpose of this study was to explore the mechanisms ofpostoperative intestinal motility disorders in intestinal atresia patients byinvestigating the expression profiles of proteins, including calretinin (CR),glial-derived neurotrophic factor (GDNF), bone morphogenetic protein2(BMP-2), and c-kit, to decipher the correlation between the area of thepathological segment and the alteration of the above4proteins; and thereby toprovide a clinical specific reference values to determine the removal length forintestinal tract resection.Methods: Immunohistochemistry technique was applied to detect the CR,c-kit, GDNF, BMP-2,protein in specimens of atretic, proximal, and distalintestine from25cases of intestinal atresia and samples of intestinal wallsfrom10non-atresia control specimens. The alteration of the enteric nervoussystem, nerve growth and its regulatory factors, the interstitial cells of Cajal(ICCs), and the enteric muscle system were examined, with particularattention being paid to pathological changes and the lesion area.Results: The expression of all of the abovementioned4proteins in theproximal side of the atresia was significantly lower than in control group. The expression of the abovementioned proteins tended to be higher farther awayfrom the atresia site. The expressions of both GDNF and BMP-2had returnedto normal level at10cm proximal to the atresia site, whereas the expressionsof CR and c-kit protein only returned to normal at15cm proximal to theatresia site. On the distal side, the expression of all6markers at3cm distal tothe atresia site was normal.Conclusion: Pathological deterioration of the myenteric ganglia,nerve growth factor, and ICCs are the causes of intestinal motility disordersafter the surgical repair of intestinal atresia. We suggest that, if thecondition of patients’ intestinal lengths allows it, surgical excisions of theintestinal tract as far as possible. To a large extent, this procedure preventedthe severe complications caused by the delayed recovery of postoperativeenteric function and thereby enhanced the survival rates. In our observationsurgical excisions of the intestinal tract from15cm proximal and from3cm distal to the atresia maybe a reasonable length. However, it is actuallydetermined by the individual conditions...