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Regarding intraop decision making in HD

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quote from "Pediatric Colorectal Conundrums: Case Studies: From Fundamental to Advanced (Pediatric Colorectal Surgery)" by Marc Levitt, Thomas Xu, Hussein Wissanji -

"A colonic resection based solely on a frozen section must be avoided in patients who have an aganglionic zone proximal to the left colon. This is because proximal to the splenic flexure you cannot expect to see hypertrophic nerves (the sacral plexus does not innervate that bowel). Therefore, you are completely dependent upon your pathologist identifying ganglion cells on frozen section which is prone to sampling bias /false negatives. This is due to artifact in the tissue that can occur from the freezing process. Consequently, you risk resection of good bowel that was incorrectly deemed aganglionic by frozen section."

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