Xia Xingrong,Liu Yuanmei,Zhou Wankang,et al.Comparative efficacy analysis of robot-assisted Swenson-like surgery versus laparoscopic modified Soave surgery for Hirschsprung’s disease in older children[J].Journal of Clinical Pediatric Surgery,,():417-423.[doi:10.3760/cma.j.cn101785-20260122-00037]
Comparative efficacy analysis of robot-assisted Swenson-like surgery versus laparoscopic modified Soave surgery for Hirschsprung’s disease in older children
- Keywords:
- Hirschsprung Disease; Robotic Surgical Procedure; Laparoscopes; Postoperative Complications
- Abstract:
- Objective To explore the clinical efficacy of da Vinci robot-assisted laparoscopic Swenson-like total colectomy in older children (age ≥ 4 years) with Hirschsprung’s disease (HSCR).Methods From January 2011 to January 2025,retrospective analysis was conducted for the relevant clinical data of 60 operated HSCR children aged ≥4 year.There were 34 boys and 26 girls with an age range of (4-18) year.They were assigned into two groups based upon specific surgical approaches.Swenson-like group (n=21) received robot-assisted Swenson-like megacolon resection while modified Soave group (n=39) underwent modified laparoscopic Soave megacolon resection.Data collected included surgical age,gender,preoperative complications,operative duration,manipulation time and postoperative hospitalization duration.The incidence of postoperative complications of anastomotic leakage,enterocolitis,fecal incontinence,anastomotic stenosis,recurrent constipation and perianal dermatitis was compared between two groups.Bowel function score (BFS) and postoperative fecal continence (POFC) were employed for assessing defecation frequency and fecal incontinence frequency and checking defecation control in two groups over a period of (1-3) year postoperatively.Results Operative duration for Swenson-like group [51.5(45.0,56.5) vs. 65.0(55.0,80.0)min],total operative duration [(249.33±40.33) vs. (286.87±30.44)min],length of bowel dissected through anus [(1.32±0.26) vs. (3.57±0.95)cm]and postoperative hospital stay [9.0(9.0,9.0) vs. 10.0(9.0,19.5)day]were all shorter than those in modified Soave group.Overall postoperative complication rate (4/21 vs. 17/39) and postoperative dilation rate (0/21 vs. 26/39) were lower in Swenson-like group while BFS score 1-3 years after surgery was higher than that in modified Soave group.All these differences were statistically significant (P<0.05).No statistically significant inter-group differences existed in the incidence rates of anastomotic leakage,small intestinal colitis,soiling,anastomotic stenosis,recurrent constipation and perianal dermatitis,as well as POFC scores 1-3 years after surgery (P>0.05).No urinary system-related complications occurred in neither group.Conclusion In older children,robotic-assisted Swenson-like total colectomy of HSCR has demonstrates distinct advantages over modified laparoscopic Soave’s procedure,including shorter anal manipulation time and lower fecal incontinence incidence.And the technique eliminates the need for routine anal dilation,thereby improving short-term postoperative defecation function and quality-of-life in children.However,its long-term efficacy requires further follow-up observations.
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Memo
收稿日期:2026-1-22。
基金项目:贵州省科技厅基础研究面上项目(黔科合2025-406);贵州省卫生健康委高质量发展项目(2024GZYXKYJJXM0108)
通讯作者:郑泽兵,Email:2403674133@qq.com