Lan Menglong,Zeng Jixiao,Xu Xiaogang,et al.Application of robotic-assisted surgery in reoperation of Hirschsprung’s disease:a single-center experience[J].Journal of Clinical Pediatric Surgery,2025,(06):512-518.[doi:10.3760/cma.j.cn101785-202408051-003]
Application of robotic-assisted surgery in reoperation of Hirschsprung’s disease:a single-center experience
- Keywords:
- Hirschsprung Disease; Postoperative Complications; Reoperation; Robotic-assisted Redo Pull-through Procedure; Child
- Abstract:
- Objective To evaluate the safety and effectiveness of robotic-assisted redo pull-through procedure (RAPT) due to complications after primary pull-through procedure (PT) for Hirschsprung’s disease (HSCR),examine the reasons for reoperation and summarize surgical experiences. Methods From November 2022 to July 2024,the relevant clinical data were retrospectively reviewed for 16 children undergoing RARPT for complications after primary PT for HSCR.There were 10 boys and 6 girls.The reasons for reoperation included recurrence of constipation (n=7) (acquired aganglionosis,n=1; residual rectal muscle cuff,n=2; residual aganglionic segment or transitional zone,n=4) and anastomotic fistula (n=6)(rectovaginal fistula,n=2; anastomotic stenosis,n=3).Reoperative approaches of RAPPT included Deloyers procedure (n=7),Swenson procedure (n=7) (simultaneous residual muscle sheath resection,n=2; removal of scar granulation tissue around anastomotic fistula,n=5) and Swenson procedure with repair of rectovaginal fistula (n=2). Results The median operative duration was 315(200-510) min,bleeding volume less than 20 ml,postoperative recovery time for eating and drinking (2-7) day,initial postoperative defecation time (1-3) day and postoperative hospital stay (8-14) day.No serious intraoperative complications occurred and there was no conversion into laparotomy.One child of incomplete intestinal obstruction improved after conservative measures and was discharged.Postoperative follow-up period was (2-21) month.One child was re-hospitalized for incomplete intestinal obstruction.Another case of enterocolitis improved after enema.There were 6 cases of soiling. Conclusions RARPT is both safe and effective for postoperative complications of HSCR.
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Memo
收稿日期:2024-8-31。
基金项目:国家自然科学基金(82170528);广东省自然科学基金(2022A1515012254);广州市科技计划市校(院)联合资助项目(202201010612、2023A03J0865);广州地区临床特色技术项目(2023C-TS48);卫生健康技术重点推广项目(XM202403895)
通讯作者:曾纪晓,Email:zengjixiao@163.com