Comparison of robotic-assisted and laparoscopic-assisted anorectal pull-through for anorectal malformations: a...

In this study, we aimed to compare the efficacy of robotic-assisted anorectal pull-through (RAARP) and laparoscopic-assisted anorectal pull-through (LAARP) in treating children with anorectal malformations (ARMs).

Sixty five children with ARMs who underwent surgical treatment in our department between 2018 and 2023 were retrospectively enrolled. Patients were divided into two groups based on surgical approach: 27 cases in the RAARP group and 38 in the LAARP group. The collected data included age and weight at surgery, operation time,intraoperative blood loss,postoperative hospital stay,postoperative complications and postoperative defecation function.

No significant differences were observed in age at surgery, weight at surgery, operative time, or postoperative hospital stay (P > 0.05). the intraoperative blood loss in the RAARP group were significantly lower than that in the LAARP group (P < 0.05). No statistically significant difference was observed in the complication rates between the two groups (P > 0.05). The total hospitalization cost in the RAARP group were significantly higher than LAARP group (P < 0.05). The RAARP group demonstrated significantly better postoperative defecation function, including voluntary bowel control and soiling, compared to the LAARP group (P < 0.05), However, no significant difference was observed in the incidence of constipation (P > 0.05).

The application of RAARP in the treatment of intermediate/high-type anorectal malformations with rectourethral bulbar fistula demonstrates safety and efficacy, effectively reducing intraoperative blood loss while maintaining postoperative defecation function comparable to or better than LAARP, with satisfactory early-term outcomes.RAARP also represents a safe and feasible option for the treatment of low-type fistulous anorectal malformations, warranting consideration for clinical application.