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Primary Laparoscopic Deloyers Procedure for Long-Segment Hirschsprung�?¢�?�?��?�?�s Disease

Xiang Wang, Qixing Xiong and Qi Qin

Objective: To treat long-segment Hirschsprung's disease (HD) in children using a laparoscopic technique and discuss the surgical method and effect of this procedure.

Methods: Thirteen children with long-segment HD, who were admitted for treatment from June 2008 to October 2016, were treated with Swenson’s radical operation for HD using laparoscopic Deloyers procedure. The difficult portions of the operation included the dissection of the blood vessels of the mesocolon using a harmonic scalpel and the counterclockwise rotation of the ascending colon. The observation indexes included the surgical times, blood loss volume, postoperative complications, and stool excretion.

Results: The 13 surgeries were all completed using laparoscopy. The surgical times ranged from 142 minutes to 208 minutes, and the mean surgical time was 168 minutes. The largest intraoperative blood loss volume was 28 ml, and the other intraoperative blood loss volumes were all less than 10 ml. The postoperative complications included anastomotic leakage, enteritis, perianal skin erosion, and encopresis. One child with anastomotic leakage underwent an enterostomy and recovered after the stoma was closed two months later. All the 13 children returned to the hospital for further medical consultation after the surgery. The follow-up visits were conducted for a period of 3-48 months. The children defecated two to eight times each day after the surgery. Neither fecal incontinence nor constipation occurred in the children.

Conclusion: The laparoscopic deloyers procedure for longsegment HD is safe, feasible, and effective.