WOFAPS 2025 8th World Congress of Pediatric Surgery

Fatih Turgul ¹, Can İhsan Öztorun ², Elif Emel Erten ¹, Esra Karakuş ³, Merve Meryem Kıran ³, Vildan Selin Çayhan ¹, Ahmet Ertürk ², Süleyman Arif Bostancı ², Aslı Nur Abay ¹, Sabri Demir ¹, Müjdem Nur Azılı ², Emrah Şenel ²

¹ Ankara Bilkent City Hospital Department of Pediatric Surgery, Ankara
² Ankara Yıldırım Beyazıt Unıversıty Medical Faculty Department of Pediatric Surgery
³ Ankara Bilkent City Hospital Department of Pathology, Ankara

Introduction:
Dolichocolon is a significant anatomical contributor to chronic constipation in children that is unresponsive to medical therapy. Surgical resection of the redundant sigmoid colon is an established treatment, but the optimal surgical approach remains a subject of debate. This study compares the clinical and functional outcomes of laparoscopic-assisted versus open sigmoid resection in pediatric patients with dolichocolon and intractable constipation.

Methods:
This retrospective study included 20 pediatric patients who underwent sigmoid resection for dolichocolon between 2019 and 2025. All patients had experienced chronic constipation resistant to dietary modifications, laxatives, enemas, and behavioral therapy for at least one year and were diagnosed via colon imaging. Fourteen patients underwent laparoscopic-assisted sigmoid resection, while 6 underwent open surgery. Data on demographic characteristics, surgical technique, hospital stay duration, postoperative complications, bowel function outcomes, and continence status were analyzed. Functional outcomes were assessed by comparing preoperative and postoperative bowel movement frequency and stool consistency.

Results:
A total of 20 pediatric patients, consisting of 8 males and 12 females with a mean age of 11.7 ± 4.7 years, underwent sigmoid resection for dolichocolon. Fourteen of these patients underwent laparoscopic-assisted surgery, while six patients were treated with an open surgical approach.

The average hospital stay was significantly shorter in the laparoscopic group, with a mean of 10.3 days, compared to 17.5 days in the open surgery group. Postoperative complications were also less frequent in the laparoscopic group, where only one patient developed a minor wound infection that resolved with conservative management. In contrast, three patients in the open surgery group experienced postoperative complications, including wound infection, ileus, and prolonged postoperative pain.

At a mean follow-up duration of 13 months, all patients exhibited improvement in bowel movement frequency and stool consistency compared to preoperative status. However, the laparoscopic group showed faster functional recovery and earlier return to daily activities. Additionally, postoperative patient comfort and cosmetic outcomes were notably better in the laparoscopic group.

Conclusion:
Laparoscopic-assisted sigmoid resection is a safe and effective surgical option for pediatric patients with dolichocolon and refractory constipation. Compared to open surgery, the laparoscopic approach offers advantages in shorter hospital stay, fewer postoperative complications, and enhanced functional recovery. Thus, it should be considered the preferred surgical strategy in suitable patients.