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Robotic Soave pull-through procedure for Hirschsprung's disease in children under 12-months: long-term outcomes
Carlos Delgado-Miguel1,2, Juan I Camps3
1Department of Pediatric Surgery, Prisma Health Children's Hospital, 9 Richland Medical Park Dr, Columbia, SC, 29203, USA. carlosdelgado84@hotmail.com.
Insights
The robotic Soave pull-through (RSPT) procedure is safe and effective for treating Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Minimally Invasive Surgery
Background:
- Hirschsprung's disease (HSCR) is a congenital condition affecting the large intestine.
- The Soave pull-through procedure is a standard surgical approach for HSCR.
- Robotic-assisted surgery offers potential advantages in complex pediatric procedures.
Purpose of the Study:
- To evaluate the long-term outcomes of the robotic Soave pull-through (RSPT) procedure.
- To assess the safety and efficacy of RSPT in infants under 12 months with HSCR.
Main Methods:
- A prospective observational study included 15 infants under 12 months with HSCR.
- Data collected included demographics, surgical details, complications, and long-term functional outcomes.
- Follow-up duration was a median of 79 months.
Main Results:
- The median age at surgery was 4 months.
- One patient experienced partial anastomosis dehiscence requiring reoperation.
- No fecal incontinence or significant soiling was reported; mild constipation and enterocolitis occurred in a few patients.
Conclusions:
- The robotic Soave pull-through (RSPT) procedure is a safe and effective surgical option for HSCR in young children.
- RSPT demonstrates favorable long-term continence outcomes with a low complication rate.
Purpose:
To describe the long-term outcomes of the robotic Soave pull-through (RSPT) procedure for Hirschsprung's disease (HSCR) in children younger than 12 months.
Methods:
A prospective observational study was conducted on HSCR patients under 12 months of age who underwent RSPT at our institution between 2011 and 2020. Data regarding demographics, clinical features, technical details, operative time, hospital stay, postoperative complications, and long-term outcomes were prospectively collected.
Results:
A total of 15 patients (9 male; 6 female) were included, with a median age at surgery of 4 months (interquartile range 3-6), and a mean weight of 6.8 ± 1.3 kg. Twelve patients suffered from rectosigmoid aganglionosis and three from long HSCR (extending up to the hepatic flexure). The mean total operative time was 240 ± 72 min. The median hospital stay was 3 days (interquartile range 3-4). Partial anastomosis dehiscence was observed in one patient, requiring reoperation on the 4th postoperative day. With a median follow-up of 79 months (interquartile range 45-115), no fecal incontinence or mild soiling were observed. Constipation occurred in two patients and mild enterocolitis in one case.
Conclusion:
RSPT procedure for Hirschsprung's disease in children younger than 12 months is a safe and effective procedure, with few complications and satisfactory long-term continence outcomes.
