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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

NEW INSIGHTS IN THE DIAGNOSIS AND MANAGEMENT OF HIRSCHSPRUNG’S DISEASE

Tran, Quoc Viet 17 January 2018 (has links) (PDF)
Hirschsprung’s disease is a common pathology in pediatric surgery. Besides, long-term outcome of surgically-treated patients remains a crucial issue. The management of Hirschsprung’s disease has remarkably advanced over the years, but difficulties persist particularly in the developing countries (such as Vietnam), where essential diagnostic procedures, such as preoperative histopathological exploration techniques/ facilities (mainly for acetylcholinesterase staining), or adequate postoperative management and follow-up requirements are unavailable.We, therefore, contemplated to work-out a relevant histo-diagnostic approach to overcome these constraints that limit our diagnostic approaches, namely, in Vietnam, and we introduced a “less-demanding” diagnostic approach, namely calretinin immunohistochemical staining which is known to be adequate for formalin-fixed tissues (and thus not necessitating frozen section equipment). We thus used calretinin immunohistochemistry in a prospective study on a large cohort of Vietnamese HD cases. Results showed that rectal suction biopsy using calretinin immunohistochemistry provides an effective histopathological diagnostic tool that can replace AChE and provides a valuable evaluating approach for both preoperative and postoperative management.In addition, we also studied long-term outcome in operated patients and impact of postoperative morbidities on their quality of life. Indeed, a long-term multidisciplinary management with dedicated procedures such as anorectal manometry is essentially required for patients with severe defecation disorders. / Doctorat en Sciences biomédicales et pharmaceutiques (Médecine) / info:eu-repo/semantics/nonPublished

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