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Purpose <p>This study evaluates the efficacy and safety of laparoscopic-assisted transanal Soave procedure (LATSP) in children with refractory constipation unrelated to Hirschsprung’s disease, addressing the paucity of evidence for surgical management in this population.</p> Methods <p>A single-center retrospective cohort of 30 children (median age: 4 years; range: 1–13) underwent LATSP after failing ≥ 6 months of standardized conservative therapy (dual laxatives + biofeedback). Preoperative evaluation excluded structural/neurogenic etiologies via MRI, barium enema, anorectal manometry, and rectal biopsy confirming the presence of ganglion cells. Primary outcomes included Symptom Severity (SS) scores (0–65) and Bristol Stool Form Scale (BSFS) at 6/24/36 months postoperatively. Complications were graded by Clavien-Dindo.</p> Results <p>SS scores decreased from 29.1 ± 9.1 preoperatively to 9.2 ± 3.3 at 36 months (<i>P</i> &lt; 0.001). Stool normalization (BSFS Types 4–5) increased from 10% to 73.4% (<i>P</i> &lt; 0.001). Four complications occurred (13.3%): fecal incontinence (<i>n</i> = 2, Grade II), anal bleeding (<i>n</i> = 1, Grade I), and presacral infection (<i>n</i> = 1, Grade IIIb), all resolved without sequelae. LATSP showed superior symptom resolution versus historical Malone ACE cohorts (73.4% vs. 20% at 6 years).</p> Conclusions <p>LATSP is a safe and effective intervention for carefully selected children with refractory constipation, providing sustained symptom relief without permanent stomas. Multidisciplinary postoperative protocols are essential for optimal outcomes.</p>

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Laparoscopic-assisted transanal soave for refractory constipation in children: outcomes and management

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月3日

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  • Zhenhua Yang,
  • Lei Huang,
  • Yanhang Fu,
  • Bin Jiang,
  • Zhifeng Liu

摘要

Purpose

This study evaluates the efficacy and safety of laparoscopic-assisted transanal Soave procedure (LATSP) in children with refractory constipation unrelated to Hirschsprung’s disease, addressing the paucity of evidence for surgical management in this population.

Methods

A single-center retrospective cohort of 30 children (median age: 4 years; range: 1–13) underwent LATSP after failing ≥ 6 months of standardized conservative therapy (dual laxatives + biofeedback). Preoperative evaluation excluded structural/neurogenic etiologies via MRI, barium enema, anorectal manometry, and rectal biopsy confirming the presence of ganglion cells. Primary outcomes included Symptom Severity (SS) scores (0–65) and Bristol Stool Form Scale (BSFS) at 6/24/36 months postoperatively. Complications were graded by Clavien-Dindo.

Results

SS scores decreased from 29.1 ± 9.1 preoperatively to 9.2 ± 3.3 at 36 months (P < 0.001). Stool normalization (BSFS Types 4–5) increased from 10% to 73.4% (P < 0.001). Four complications occurred (13.3%): fecal incontinence (n = 2, Grade II), anal bleeding (n = 1, Grade I), and presacral infection (n = 1, Grade IIIb), all resolved without sequelae. LATSP showed superior symptom resolution versus historical Malone ACE cohorts (73.4% vs. 20% at 6 years).

Conclusions

LATSP is a safe and effective intervention for carefully selected children with refractory constipation, providing sustained symptom relief without permanent stomas. Multidisciplinary postoperative protocols are essential for optimal outcomes.