Clinical Efficacy of Laparoscopic Modified Soave Procedure for Hirschsprung's Disease: A Retrospective Cohort Comparative Study

Chuncan Ma^1,2Yong Li³Yalan Xia⁴Xintao Zhang¹Qiongqian Xu¹Xixi He¹Dong Sun¹Jichang Han¹Xue Ren¹Dongming Wang¹Jian Wang¹Li Aiwu^5*

• ¹Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, China
• ²Fifth Department of general Surgery (First Affiliated Hospital of Jishou University), People's Hospital of Xiangxi Tujia and Miao Autonomous Prefecture, Jishou, China
• ³Second Department of general surgery, Hunan Children's Hospital, Changsha, China
• ⁴First Department of Cardiovascular (First Affiliated Hospital of Jishou University), People's Hospital of Xiangxi Tujia and Miao Autonomous Prefecture, Jishou, China
• ⁵Department of Pediatric Surgery, Qilu Hospital, Shandong University, Jinan, China

Background: Hirschsprung's disease (HSCR) is the second most common congenital gastrointestinal malformation, posing a significant health concern in pediatrics. The laparoscopic modified Soave procedure, a minimally invasive technique, has gained popularity due to its potential advantages. This study aims to evaluate its clinical efficacy in comparison with the traditional transanal Soave procedure. Methods: This retrospective cohort comparative study included children with HSCR treated at Qilu Hospital between January 2014 and January 2024. Patients were divided into two groups: the Laparoscopic group (undergoing the laparoscopic modified Soave procedure) and the Transanal group (undergoing the transanal Soave procedure). Outcomes assessed included postoperative recovery metrics, complication rates, and one-year follow-up results. Results: 96 patients were included in study. Compared with the Transanal group, the Laparoscopic group demonstrated reduced surgical time, faster gastrointestinal recovery, and reduced hospital stay compared to the Transanal group (P< 0.05). Intraoperative blood loss was greater in the Laparoscopic group (P<0.05). Complication rates were lower in the Laparoscopic group (4.17%) than in the Transanal group (14.58%), although the difference was not statistically significant (P>0.05). Notably, the incidence of postoperative abdominal distension was significantly lower in the Laparoscopic group (P<0.05), with no significant differences observed in other follow-up outcomes (P>0.05). Conclusion: The laparoscopic modified Soave procedure demonstrates superior clinical efficacy compared to the transanal approach, offering faster recovery and a trend toward fewer complications. These findings support its wider adoption as a minimally invasive treatment option for HSCR.