Robotic-assisted proctosigmoidectomy for Hirschsprung’s disease:A multicenter prospective study  

作　　者：Meng-Xin Zhang Xi Zhang Xiao-Pan Chang Ji-Xiao Zeng Hong-Qiang Bian Guo-Qing Cao Shuai Li Shui-Qing Chi Ying Zhou Li-Ying Rong Li Wan Shao-Tao Tang 

机构地区：[1]Department of Pediatric Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Hubei Province,China [2]Department of Pediatric Surgery,Guangzhou Women and Children’s Medical Center,Guangzhou Medical University,Guangzhou 510623,Guangdong Province,China [3]Department of General Surgery,Wuhan Children’s Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430019,Hubei Province,China

出　　处：《World Journal of Gastroenterology》2023年第23期3715-3732,共18页世界胃肠病学杂志（英文版）

基　　金：Supported by the National Health and Family Planning of China,No.201402007;the National Natural Science Foundation of China,No.81873848 and No.82170528.

摘　　要：BACKGROUND Robotic surgery is a cutting-edge minimally invasive technique that overcomes many shortcomings of laparoscopic techniques,yet few studies have evaluated the use of robotic surgery to treat Hirschsprung’s disease(HSCR).AIM To analyze the feasibility and medium-term outcomes of robotic-assisted proctosigmoidectomy(RAPS)with sphincter-and nerve-sparing surgery in HSCR patients.METHODS From July 2015 to January 2022,156 rectosigmoid HSCR patients were enrolled in this multicenter prospective study.Their sphincters and nerves were spared by dissecting the rectum completely from the pelvic cavity outside the longitudinal muscle of the rectum and then performing transanal Soave pull-through procedures.Surgical outcomes and continence function were analyzed.RESULTS No conversions or intraoperative complications occurred.The median age at surgery was 9.50 months,and the length of the removed bowel was 15.50±5.23 cm.The total operation time,console time,and anal traction time were 155.22±16.77,58.01±7.71,and 45.28±8.15 min.There were 25 complications within 30 d and 48 post-30-d complications.For children aged≥4 years,the bowel function score(BFS)was 17.32±2.63,and 90.91%of patients showed moderate-to-good bowel function.The postoperative fecal continence(POFC)score was 10.95±1.04 at 4 years of age,11.48±0.72 at 5 years of age,and 11.94±0.81 at 6 years of age,showing a promising annual trend.There were no significant differences in postoperative complications,BFS,and POFC scores related to age at surgery being≤3 mo or>3 mo.CONCLUSION RAPS is a safe and effective alternative for treating HSCR in children of all ages;it offers the advantage of further minimizing damage to sphincters and perirectal nerves and thus providing better continence function.

关 键 词：ROBOTIC-ASSISTED Hirschsprung’s disease Continence function SPHINCTER NERVE 

分 类 号：R726.5[医药卫生—儿科]