Outcomes of Laparoscopic Soave's Pull-Through in Children with Hirschsprung's Disease: A Retrospective Analysis
Authors/Creators
- 1. Associate Professor & Senior Surgical Specialist in General Surgery, ANIIMS & GB Pant Hospital, Port Blair - 744104, India
- 2. Senior Resident, in General Surgery, ANIIMS & GB Pant Hospital, Port Blair - 744104, India
- 3. Junior Resident in General Surgery, ANIIMS & GB Pant Hospital, Port Blair 744104, India
- 4. Professor in General Surgery, AIIMS, Deoghar, Jharkhand 814152, India
- 5. Senior Resident in General Surgery, ANIIMS & GB Pant Hospital, Port Blair 744104, India
Description
Background: Hirschsprung’s disease, a congenital disorder characterized by the absence of ganglion cells in the distal bowel, necessitates surgical intervention to alleviate obstructive symptoms and restore bowel function. Laparoscopic Soave’s pull-through has emerged as a promising minimally invasive approach for the surgical management of this condition, offering potential advantages in terms of operative outcomes and postoperative recovery. Methods: A retrospective analysis was conducted to evaluate the outcomes of laparoscopic Soave’s pull-through in children with Hirschsprung’s disease. Electronic medical records of patients undergoing the procedure between July 2012 and June 2022 were comprehensively reviewed. Data collection included demographic information, preoperative evaluation findings, surgical details, perioperative outcomes, postoperative follow-up data, and long-term functional outcomes. Surgical technique adhered to standardized protocols, with meticulous attention to dissection and preservation of rectal innervation. Results: A total of 49 patients underwent laparoscopic Soave’s pull-through, with a mean age of 2.8 1.2 years. The mean operative time was 160.9 ± 35.4 minutes, with a low conversion rate to open surgery (6.1%) and no intraoperative complications. Postoperative complications were observed in 24.5% of cases, including wound infections (6.1%), anastomotic leaks (4.1%), and strictures (8.2%). Long-term functional outcomes were favorable, with a mean HD Bowel Function Score of 9.2 ± 1.5. The majority of patients achieved fecal continence (81.6%) and reported stooling frequency within the normal range of 61.2% with 1-2 times/day. Conclusion: Laparoscopic Soave’s pull-through demonstrates favorable perioperative and long-term functional outcomes in children with Hirschsprung’s disease. The minimally invasive approach offers efficient bowel function restoration while minimizing surgical morbidity. Despite the observed complications, the overall efficacy and safety of laparoscopic Soave’s pull-through highlight its potential as a preferred surgical option in the management of Hirschsprung’s disease.
Abstract (English)
Background: Hirschsprung’s disease, a congenital disorder characterized by the absence of ganglion cells in the distal bowel, necessitates surgical intervention to alleviate obstructive symptoms and restore bowel function. Laparoscopic Soave’s pull-through has emerged as a promising minimally invasive approach for the surgical management of this condition, offering potential advantages in terms of operative outcomes and postoperative recovery. Methods: A retrospective analysis was conducted to evaluate the outcomes of laparoscopic Soave’s pull-through in children with Hirschsprung’s disease. Electronic medical records of patients undergoing the procedure between July 2012 and June 2022 were comprehensively reviewed. Data collection included demographic information, preoperative evaluation findings, surgical details, perioperative outcomes, postoperative follow-up data, and long-term functional outcomes. Surgical technique adhered to standardized protocols, with meticulous attention to dissection and preservation of rectal innervation. Results: A total of 49 patients underwent laparoscopic Soave’s pull-through, with a mean age of 2.8 1.2 years. The mean operative time was 160.9 ± 35.4 minutes, with a low conversion rate to open surgery (6.1%) and no intraoperative complications. Postoperative complications were observed in 24.5% of cases, including wound infections (6.1%), anastomotic leaks (4.1%), and strictures (8.2%). Long-term functional outcomes were favorable, with a mean HD Bowel Function Score of 9.2 ± 1.5. The majority of patients achieved fecal continence (81.6%) and reported stooling frequency within the normal range of 61.2% with 1-2 times/day. Conclusion: Laparoscopic Soave’s pull-through demonstrates favorable perioperative and long-term functional outcomes in children with Hirschsprung’s disease. The minimally invasive approach offers efficient bowel function restoration while minimizing surgical morbidity. Despite the observed complications, the overall efficacy and safety of laparoscopic Soave’s pull-through highlight its potential as a preferred surgical option in the management of Hirschsprung’s disease.
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IJPCR,Vol16,Issue5,Article206.pdf
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Additional details
Dates
- Accepted
-
2024-05-10
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue5,Article206.pdf
- Development Status
- Active
References
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