Clinical outcomes and ergonomics analysis of three laparoscopic techniques for Hirschsprung's disease

Table 1 General characteristics, operative data, and complications n (%)

Characteristic	CLP (n = 30)	SILP (n = 28)	H-SILP (n = 32)	P value
Median age (mo) (range)	3.8 ± 2.6 (1.0-90.2)	3.4 ± 2.1 (1.0-78.8)	3.6 ± 2.1 (1.0-78.6)	> 0.05
Sex, male	21 (70.0)	18 (64.3)	24 (75.0)	> 0.05
General operative time (min)	115 ± 22 (75-156)	118 ± 22 (90-178)	115 ± 24 (75-158)	> 0.05
Conversion to open surgery	0	0	0	> 0.05
Estimated blood loss (mL)	5.0 ± 1.0	6.0 ± 1.5	4.5 ± 1.0	> 0.05
Hospital stays (d)	7.0 ± 1.5	7.0 ± 1.0	7.0 ± 1.0	> 0.05
Intraoperative complications	0	0	0	> 0.05
Time of passage of flatus (h)	22.0 ± 5.0	21.5 ± 4.5	21.5 ± 4.0	> 0.05
Early postoperative complications	11 (36.7)	8 (33.3)	8 (31.3)	> 0.05
Perianal excoriation	10 (33.3)	7 (25.0)	9 (28.1)
Anastomotic leak	1 (3.3)	0	0
Enterocolitis	0	1 (3.6)	1 (3.1)
Defecation frequency, times per day
1 wk postoperatively	5 ± 4	6 ± 4	5 ± 4	> 0.05
1 mo postoperatively	4 ± 2	4 ± 3	4 ± 2	> 0.05
3 mo postoperatively	2 ± 1	2 ± 1	2 ± 1	> 0.05
Recurrent constipation	0	0	0	> 0.05

CLP: Conventional laparoscopic pull-through; SILP: Single-incision laparoscopic pull-through; H-SILP: Hybrid single-incision laparoscopic pull-through.

Table 2 Operative time among the three procedure groups relative to the age and transitional zone

Group	CLP(n = 30)	SILP(n = 28)	H-SILP(n = 32)
Patients < 1 yr of age, n	21	20	22
Operative time (min)	113 ± 23	109 ± 8	113 ± 12
Patients > 1 yr of age, n	9	8	10
Operative time	120 ± 15a	140 ± 7	119 ± 12a
Rectosigmoid colon, n	27	26	27
Operative time (min)	111 ± 20	114 ± 17	109 ± 20
Descending colon, n	3	2	5
Operative time (min)	152 ± 4a	176 ± 2	154 ± 4a

^aP < 0.05 vs SILP. CLP: Conventional laparoscopic pull-through; SILP: Single-incision laparoscopic pull-through; H-SILP: Hybrid single-incision laparoscopic pull-through.

Table 3 Cosmetic assessment

Assessment	CLP(n = 30)	SILP(n = 28)	H-SILP(n = 32)	P value
Number of visible scars on the abdomen	2	0	1	-
Scar appearance on the abdomen	Visible	Scarless	Near scarless	-
MSS score of visible scar on the abdomen	10.00 ± 0.72 (good)	-	5.00 ± 0.72 (excellent)	< 0.05
Appearance at the umbilicus	Normal	Normal	Normal	-

CLP: Conventional laparoscopic pull-through; SILP: Single-incision laparoscopic pull-through; H-SILP: Hybrid single-incision laparoscopic pull-through; MSS: Manchester scar scale.

Table 4 Manchester scar scale: 5 (best) to 18 (worse)

Category	Visual analog scale descriptor	Poor
Color	Perfect	1
	Slight mismatch	2
	Obvious mismatch	3
	Gross mismatch	4
Matte vs shiny	Matte	1
	Shiny	2
Contour	Flush with surrounding skin	1
	Slightly proud/indented	2
	Hypertrophic	3
	Keloid	4
Distortion	None	1
	Mild	2
	Moderate	3
	Severe	4
Texture	Normal	1
	Just palpable	2
	Firm	3
	Hard	4