Published online Jun 21, 2023. doi: 10.3748/wjg.v29.i23.3715
Peer-review started: March 16, 2023
First decision: April 21, 2023
Revised: April 29, 2023
Accepted: May 22, 2023
Article in press: May 22, 2023
Published online: June 21, 2023
Processing time: 92 Days and 0.1 Hours
Robotic-assisted surgery has been gradually introduced and applied to treat children with Hirschsprung’s disease (HSCR). However, few studies have been conducted to evaluate its safety and efficacy for HSCR treatment.
We aimed to investigate the medium-term outcomes of robotic-assisted surgery for treating HSCR.
We aimed to analyze the feasibility and efficacy of robotic-assisted proctosigmoidectomy (RAPS) with sphincter- and nerve-sparing surgery (SNS) in the treatment of HSCR.
We conducted a multicenter prospective study of 156 infants with rectosigmoid HSCR who underwent SNS-RAPS and divided them by age into a younger group (aged ≤ 3 mo) and an older group (aged > 3 mo) for comparison. Intraoperative data, postoperative complications, and medium-term outcomes were recorded and analyzed. In patients aged ≥ 4 years, the bowel function score (BFS) was used to assess overall bowel function, and the postoperative fecal continence (POFC) score was used to evaluate SNS-related incontinence.
A total of 156 patients underwent successful SNS-RAPS, with 25 complications within 30 d and 48 post-30-d complications after surgery. For children aged ≥ 4 years, the overall BFS was 17.32 ± 2.63 and 90.91% of patients showed moderate-to-good bowel function, while the POFC score increased annually from 4 to 6 years old (4 years old: 10.95 ± 1.04, 5 years old: 11.48 ± 0.72, 6 years old: 11.94 ± 0.81). There were no significant differences between the younger and older groups in postoperative complications and POFC score.
SNS-RAPS is a safe and effective alternative treatment for children of all ages with HSCR. It provides the advantage of further minimizing damage to sphincters and perirectal nerves, thus providing better continence function.
Robotic-assisted surgery is beneficial for treating HSCR in infants and young children.