Journal of pediatric surgery · 2026
Comparative of Robotic-Assisted versus Laparoscopic-Assisted Modified Soave Pull-Through with Short Muscular Cuff Anastomosis in Infants Under 3 Months with Classical Hirschsprung Disease.
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Wang Bo, Tang Chengyan, Xia Xinrong, Gong Yuan, Du Qing, Zhu Daiwei, Li Zeping, Zhou Wangkan, Wang Yuanli, He Shengying, Li Yanyi, Jin Zhu, Liu Yuanmei, Zheng Zebing
Аннотация
OBJECTIVE: To compare the clinical efficacy of robotic-assisted versus laparoscopic-assisted modified Soave pull-through with short muscular cuff anastomosis in infants under 3 months of age with classical Hirschsprung's disease (HSCR).
METHODS: A retrospective analysis was conducted on 35 infants under 3 months with classical HSCR who underwent radical surgery at our hospital from January 2020 to December 2024. Among them, 19 underwent robotic-assisted surgery (robotic group), and 16 underwent laparoscopic-assisted surgery (laparoscopic group). Baseline characteristics, perioperative outcomes, postoperative complications, and defecation function were compared between the two groups.
RESULTS: Baseline characteristics were comparable between groups (P > 0.05). Compared with the laparoscopic group, the robotic group had significantly shorter total operative time [(142.5±16.8) min vs. (171.3±24.6) min; P < 0.05], shorter anal dissection time [(20.8±5.2) min vs. (36.7±9.8) min; P < 0.05], less intraoperative blood loss [(6.5±2.4) ml vs. (11.0±5.6) ml; P < 0.05], and shorter postoperative hospital stays [(7.2±1.6) d vs. (8.9±2.4) d; P < 0.05]. The incidence of postoperative enterocolitis was significantly lower in the robotic group [0(0%) vs. 4(25.0%); P < 0.05]. Regarding defecation function, the robotic group showed fewer daily soiling episodes [(0.8±0.6) vs. (1.6±0.9); P < 0.05] and higher Kelly scores [(2.9±0.3) points vs. (2.4±0.7) points; P < 0.05]. No significant differences were observed between the two groups in terms of anastomotic complications, need for constipation intervention, daily bowel movement frequency, or excellent rate of defecation function (P > 0.05).
CONCLUSION: In this non-randomized, retrospective comparison, robotic-assisted modified Soave pull-through with short muscular cuff anastomosis was found to be safe and feasible for infants under 3 months with classical HSCR. The robotic approach was associated with shorter operative time, reduced intraoperative blood loss, shorter hospital stays, and may be associated with improved mid-term defecation function compared with laparoscopic assistance.
METHODS: A retrospective analysis was conducted on 35 infants under 3 months with classical HSCR who underwent radical surgery at our hospital from January 2020 to December 2024. Among them, 19 underwent robotic-assisted surgery (robotic group), and 16 underwent laparoscopic-assisted surgery (laparoscopic group). Baseline characteristics, perioperative outcomes, postoperative complications, and defecation function were compared between the two groups.
RESULTS: Baseline characteristics were comparable between groups (P > 0.05). Compared with the laparoscopic group, the robotic group had significantly shorter total operative time [(142.5±16.8) min vs. (171.3±24.6) min; P < 0.05], shorter anal dissection time [(20.8±5.2) min vs. (36.7±9.8) min; P < 0.05], less intraoperative blood loss [(6.5±2.4) ml vs. (11.0±5.6) ml; P < 0.05], and shorter postoperative hospital stays [(7.2±1.6) d vs. (8.9±2.4) d; P < 0.05]. The incidence of postoperative enterocolitis was significantly lower in the robotic group [0(0%) vs. 4(25.0%); P < 0.05]. Regarding defecation function, the robotic group showed fewer daily soiling episodes [(0.8±0.6) vs. (1.6±0.9); P < 0.05] and higher Kelly scores [(2.9±0.3) points vs. (2.4±0.7) points; P < 0.05]. No significant differences were observed between the two groups in terms of anastomotic complications, need for constipation intervention, daily bowel movement frequency, or excellent rate of defecation function (P > 0.05).
CONCLUSION: In this non-randomized, retrospective comparison, robotic-assisted modified Soave pull-through with short muscular cuff anastomosis was found to be safe and feasible for infants under 3 months with classical HSCR. The robotic approach was associated with shorter operative time, reduced intraoperative blood loss, shorter hospital stays, and may be associated with improved mid-term defecation function compared with laparoscopic assistance.