Severe perioperative complications of laparoscopically assisted soave radical resection for Hirschsprung’s disease

Objective To explore the occurrence and management of perioperative complications of laparoscopically assisted soave radical resection for Hirschsprung’s disease. Methods Retrospective analysis of 632 cases of laparoscopically assisted Soave radical resection for Hirschsprung’s disease from October 2007 to October 2017. There were 376 boys and 256 girls with a ratio of 47∶32. The average age was 97(76-118) days and the average weight 4 500(4 200-5 900) grams. The clinical types were common (n=562, 88.92%) and long-segment (n=70, 11.08%). Perioperative complications occurred due to celiac bleeding (n=5), intestinal perforation (n=3), colonic twisting (n=3), colonic prolapse (n=2), internal hemorrhoid (n=2), colon necrosis (n=2) and left ureteral injury (n=1). The types of complicated HSCR were common (n=13, 2.31%) and long-segment (n=5, 7.14%). Results Among 18 complicated cases, two cases of colonic necrosis undergoing colostomy were cured by closure after 3 months. One case of left ureteral injury was discharged with renal-pelvis drainage tube. The remaining 15 patients were fully discharged after re-operation during hospitalization. One case of colonic necrosis had medical disputes. During a follow-up period of 3-5 years, 3 cases were slightly contaminated. Other cases grew up normally without other complications. Conclusions Laparoscopically assisted Soave radical resection for Hirschsprung’s disease provides a novel surgical method for Hirschsprung’s disease, especially for long-segment type. However, we should watch out for the occurrence of severe perioperative complications. Key words: Hirschsprung disease; Therapeutic laparoscopy; Postoperative complications