Comparison of embryonic nature orifice transumbilical endoscopic surgery with conventional laparoscopic surgery treatmenting Hirschsprung disease

Abstract

Objective To compare the therapeutic effects of embryonic nature orifice transumbilical endosco-pic surgery(ENOTES) with conventional laparoscopic(CL) surgery in Hirschsprung disease(HD). Methods A total of 111 children from Sep.2009 to Dec.2010 were included in the retrospective study.The patients were divided into 2 groups: ENOTES group(66 cases) and CL group(45 cases). The general conditions of children were reviewed operative situation, postoperative complications and defecation 1 year after operation. Results In the left colectomy, there was no difference between 2 groups in age, weight, operative blood loss and postoperative stay(all P>0.05), but ENOTES took up less time than CL(P<0.05); in the subtotal colectomy, no significant difference existed in all series.All children underwent primary radical surgery, neither transfer to open surgery nor dead case.In ENOTES group, there were 9 cases suffering from enterocolitis postoperatively(13.6%), while 7 cases(15.6%) in CL group.Twenty-eight patients in ENOTES group and 12 in CL group were followed up for 1 year.Less abdominal distension postoperatively was noted in ENTOES group than CL group(P<0.05), but no other difference in other available data.In addition, no obvious operative scar was noted on the abdomen in ENOTES group, what meant better cosmetic benefit than CL. Conclusion HD treated with ENOTES can gain the same outcomes with CL with better cosmetic effect. Key words: Embryonic nature orifice transumbilical endoscopic; Conventional laparoscopic; Hirschsprung disease