Comparison of the application of laparoscopic-assisted and modified transanal Soave pull-through procedure in the treatment of popular type Hirschsprung's disease in neonates

Objective To compare the clinical effectiveness of laparoscopic-assisted and modified transanal Soave pull-through procedure in the treatment of popular type Hirschsprung's disease (HD) in neonates. Methods A total of 65 popular type HD neonates who were admitted to the Affiliated Children's Hospital of Soochow University were enrolled and their clinical data were retrospectively analyzed. According to different surgical methods, they were divided into two groups: an observation group (n=35) and a control group (n=30). The control group underwent modified transanal Soave pull-through procedure, while the observation group performed laparoscopic-assisted transanal Soave pull-through procedure. Both groups were compared for the perioperative conditions, surgical effects and complications. Results The observation group showed remarkable increases in surgical time and the length of resected bowel, decreases in the anal anatomy time and the length of postoperative hospitalization stay, and decreases in the intraoperative blood loss, compared with the control group (P<0.05). For the observation group, the excellent and good rate of anal function was 84.38% and 100% at postoperative 6 and 12 months, respectively , which were significantly higher than those in the control group (77.78% and 88.00%, both P<0.05). Compared with those before surgery, both groups presented significantly reduced resting anal pressure and increased anorectal angle at postoperative 6 and 12 months. The observation group showed remarkable increases in resting anal pressure and decrease in anorectal angle then the control group at postoperative 6 and 12 months (P<0.05). The total incidence of postoperative complications was lower in the observation group and the control group (P<0.05). Conclusions Compare with the dified anal Soave operation, laparoscopic-assisted modified anal Soave pull-through procedure is effective in the treatment of popular type HD, with little postoperative complications, with less complications and higher safety.