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<p>Hirschsprung’s disease (HSCR) is a congenital bowel disorder caused by absent enteric ganglion cells, often in neonates with intestinal obstruction. Minimally invasive surgical resection is the standard treatment. Robotic-assisted pull-through surgery (RAS) offers improved precision, but comparative data with laparoscopic-assisted surgery (LAS) is limited. This systematic review and meta-analysis evaluated postoperative outcomes between RAS and LAS in pediatric HSCR. Literature search was performed in PubMed/MEDLINE, Web of Science, Scopus, EMBASE, CINAHL, and Cochrane Library, following PRISMA guidelines. Random-effects meta-analysis with 95% confidence interval (CI) was conducted. Protocol was preregistered on PROSPERO (CRD420251033648). Four studies involving 291 pediatric patients (124 RAS, 167 LAS) were included. RAS demonstrated significantly lower blood loss (MD = −&#xa0;2.66; 95% CI −&#xa0;4.54 to −&#xa0;0.80; p &lt; 0.01) and higher hospitalization expenses (MD = 44,922.20; 95% CI 43,592.28–46,252.12; p &lt; 0.01). LAS presented shorter postoperative feed times (MD = 1.00; 95% CI 0.16–1.84; p = 0.02). No significant differences were observed in other postoperative outcomes. RAS appears to be a safe alternative to LAS in pediatric HSCR. However, no definitive clinical advantage of RAS is confirmed. Further studies are warranted to clarify its role in pediatric colorectal surgery.</p>

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Postoperative outcomes of robotic-assisted vs. laparoscopic pull-through surgery in pediatric Hirschsprung’s disease: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年7月24日

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  • Carla Isabella Miret Durazo,
  • Paloma Frei,
  • Stephanie Gail Giray Go,
  • Rafeeqa Binte Ameenuthin,
  • M. J. Marie Caragon Baptista,
  • Francesca Gabriela Ocana Diaz,
  • Yadelys Rodriguez Reyes,
  • Sylvia Oluwafunmilayo Ejinaka,
  • Abdulrahman Abdulkarim Shawish,
  • Evelyn Saavedra Reyna,
  • Saimuralidhar S. Srinivasan,
  • Stephani Carolina Salvatierra Moreno,
  • Victor Sebastan Arruarana

摘要

Hirschsprung’s disease (HSCR) is a congenital bowel disorder caused by absent enteric ganglion cells, often in neonates with intestinal obstruction. Minimally invasive surgical resection is the standard treatment. Robotic-assisted pull-through surgery (RAS) offers improved precision, but comparative data with laparoscopic-assisted surgery (LAS) is limited. This systematic review and meta-analysis evaluated postoperative outcomes between RAS and LAS in pediatric HSCR. Literature search was performed in PubMed/MEDLINE, Web of Science, Scopus, EMBASE, CINAHL, and Cochrane Library, following PRISMA guidelines. Random-effects meta-analysis with 95% confidence interval (CI) was conducted. Protocol was preregistered on PROSPERO (CRD420251033648). Four studies involving 291 pediatric patients (124 RAS, 167 LAS) were included. RAS demonstrated significantly lower blood loss (MD = − 2.66; 95% CI − 4.54 to − 0.80; p < 0.01) and higher hospitalization expenses (MD = 44,922.20; 95% CI 43,592.28–46,252.12; p < 0.01). LAS presented shorter postoperative feed times (MD = 1.00; 95% CI 0.16–1.84; p = 0.02). No significant differences were observed in other postoperative outcomes. RAS appears to be a safe alternative to LAS in pediatric HSCR. However, no definitive clinical advantage of RAS is confirmed. Further studies are warranted to clarify its role in pediatric colorectal surgery.