WOFAPS 2025 8th World Congress of Pediatric Surgery

Song Tian, Shangjie Xiao

Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China

Abstract: Objective: To investigate the safety and clinical efficacy of the laparoscopic-assisted modified Soave short muscular sheath procedure combined with enhanced recovery after surgery (ERAS) in infants (within 6 months of age) with Hirschsprung's Disease. Methods: A retrospective analysis was conducted on the clinical data of 81 infants with Hirschsprung's Disease who underwent surgical treatment at our Hospital between December 2017 and January 2025. The patients were divided into two groups.The observation group (40 cases): received the laparoscopic-assisted modified Soave short muscular sheath procedure combined with ERAS;the control group (41 cases):treated with conventional laparoscopic-assisted Soave surgery alone. Compare the baseline characteristics, perioperative parameters, postoperative recovery outcomes, and complication between the two groups.Results: No statistically significant differences were observed between the two groups in baseline characteristics (P > 0.05). The observation group demonstrated significantly shorter preoperative preparation time (2.5 ± 1.7 days), operative time (103.3 ± 23.4 minutes), time to first defecation/flatus postoperatively (1.4 ± 0.5 days), time to first oral intake (2.1 ± 0.8 days), postoperative hospital stay (4.3 ± 1.5 days), and total hospital stay (5.9 ± 2.1 days) compared to the control group (P < 0.05). All patients were followed up for 2 to 4 years. Postoperative complications occurred in 5 cases in observation group, including 4 enterocolitis and 1 recurrent constipation, with no cases of fecal soiling or incontinence.The control group experienced 13 complications (31.7%), including 8 enterocolitis,3 recurrent constipation,and 2 fecal soiling/incontinence . The complication rate was significantly lower in the observation group (P < 0.05). Conclusion:The laparoscopic-assisted modified Soave short muscular sheath procedure combined with ERAS is safe and effective for treating Hirschsprung's Disease in infants under 6 months of age,it offers advantages such as faster postoperative recovery, shorter hospitalization, and reduced complication rates.