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Comparison of transcolostomy single-incision laparoscopic and open procedures in secondary operations for hirschsprung's disease

Junmei Yan, Sanliang Li, Yan Chang, Jian Wang, Aiwu Li

The aim of this study was to report our experience with the Soave pull-through procedure combined with a single-incision laparoscopic approach to treat Hirschsprung's disease after one-stage colostomy, in comparison with an open approach. A total of 37 children diagnosed with Hirschsprung's Disease after one-stage colostomy were evaluated in this study from June 2008 to May 2014. Nineteen patients treated with the Soave pull-through combined with an open approach from June 2008 to May 2011 were in Group 1, and 18 patients treated with a single-incision (abdominal wall colostomal) laparoscopic Soave pull-through approach from June 2011 to June 2014 were in Group 2. The preoperative data, operative details, and follow-up outcomes were compared in the two groups to determine the advantages of the single-incision laparoscopic approach. Statistical comparison was made with unpaired t-tests, χ² tests and Fisher’s exact test, with P value less than 0.05 considered significant. The two groups had similar preoperative patient data to ensure comparability. The operative time in Group 2 was similar to that in Group 1, and all Group 2 cases underwent a single-incision laparoscopic approach. The postoperative time to feeding and the hospital stay after surgery were shorter in Group 2, which showed less blood loss, fewer complications, and less incidental injury. All patients were followed up for 6-12 months, and outcomes were better in Group 2. Compared to open surgery, the laparoscopic singleincision abdominal wall colostomal approach had many benefits and was effective in treatment of Hirschsprung's disease after one-stage colostomy.