Clinical significance and biological effect of ZFAS1 in Hirschsprung's disease and preliminary exploration of its underlying mechanisms using integrated bioinformatics analysis

The roles of non-coding RNAs in Hirschsprung's disease

Hirschsprung's disease (HSCR) is a congenital disorder characterized by the absence of ganglion cells in the colon, leading to various intestinal complications. The etiology of HSCR stems from complex genetic and environmental interactions, of which the intricate roles of non-coding RNAs (ncRNAs) are a key area of research. However, the roles of ncRNAs in the pathogenesis of HSCR have not been fully elucidated. In order to understand the variety of symptoms caused by HSCR and develop new therapeutic approaches, it is essential to understand the underlying biological genetic basis of HSCR. This review presents a comprehensive overview of the current understanding regarding the involvement of ncRNAs in HSCR, including microRNAs (miRNAs), long noncoding RNAs (lncRNAs), and circular RNAs (circRNAs). Additionally, it provides a summary of the molecular mechanisms through which ncRNAs regulate the expression of genes related to the proliferation, migration, and differentiation of intestinal neural crest cells, thereby contributing to the advancement of HSCR research.

The Classification and Surgical Treatments in Adult Hirschsprung’s Disease: A Retrospective Study

Purpose

To explore the treatments and short-term effects of different types of adult Hirschsprung’s disease.

Methods

89 patients treated in Shanghai Changhai Hospital were retrospectively analyzed. According to the patient’s medical history, clinical manifestations, auxiliary examination and postoperative pathological results, the patients were divided into adult congenital megacolon, adult idiopathic megacolon, ganglion cell deficiency (types I and II), toxic megacolon and iatrogenic megacolon, The Treatment methods and short-term prognosis of patients in each group were summarized.

Results

41 cases of Hirschsprung’s disease in adults and low anterior resection or pull-out low anterior resection was performed, and 35 patients with idiopathic Megacolon were treated with one-stage subtotal colon resection under the condition of adequate preoperative preparation. Some patients admitted for emergency intestinal obstruction received conservative treatment first or underwent elective surgery after colonoscopic decompression was improved; two patients with ganglion cell deficiency subtotal colectomy were performed to remove the dilated proximal bowel segment and the narrow distal bowel segment; three patients with toxic Hirschsprung’s disease underwent colostomy in mild cases, while subtotal colorectal resection was required in severe cases; Iatrogenic megacolon was diagnosed in eight cases and the optimum operation should be selected according to the specific conditions of patients.

Conclusion

Adult Hirschsprung’s diseases were divided into adult congenital hirschsprung’s disease, idiopathic Hirschsprung’s disease, ganglion cell deficiency, toxic hirschsprung’s disease, and iatrogenic Hirschsprung’s disease. Different types of surgical treatments for Hirschsprung’s disease in adults should be selected according to the specific diagnosis. All patients with adult Hirschsprung’s diseases have good short-term outcomes after surgical treatment.