Robotic Soave pull-through procedure for Hirschsprung's disease in children under 12-months: long-term outcomes.

Abstract

To describe the long-term outcomes of the robotic Soave pull-through (RSPT) procedure for Hirschsprung's disease (HSCR) in children younger than 12months. A prospective observational study was conducted on HSCR patients under 12months of age who underwent RSPT at our institution between 2011 and 2020. Data regarding demographics, clinical features, technical details, operative time, hospital stay, postoperative complications, and long-term outcomes were prospectively collected. A total of 15 patients (9 male; 6 female) were included, with a median age at surgery of 4months (interquartile range 3-6), and a mean weight of 6.8 ± 1.3kg. Twelve patients suffered from rectosigmoid aganglionosis and three from long HSCR (extending up to the hepatic flexure). The mean total operative time was 240 ± 72min. The median hospital stay was 3days (interquartile range 3-4). Partial anastomosis dehiscence was observed in one patient, requiring reoperation on the 4th postoperative day. With a median follow-up of 79months (interquartile range 45-115), no fecal incontinence or mild soiling were observed. Constipation occurred in two patients and mild enterocolitis in one case. RSPT procedure for Hirschsprung's disease in children younger than 12months is a safe and effective procedure, with few complications and satisfactory long-term continence outcomes.