{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:11:41Z","timestamp":1785449501856,"version":"3.56.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2016YFE0203900"],"award-info":[{"award-number":["2016YFE0203900"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014125","name":"Fujian Provincial Health Commission","doi-asserted-by":"publisher","award":["2018-ZQN-27"],"award-info":[{"award-number":["2018-ZQN-27"]}],"id":[{"id":"10.13039\/501100014125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> The aim of this study was to describe the details of laparoscopic-assisted reoperative surgery for Hirschsprung's disease (HSCR) with overflow fecal incontinence, and to retrospectively compare laparoscopic-assisted surgery with transabdominal pull-through surgery.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We retrospectively analyzed patients with HSCR with overflow fecal incontinence after the initial surgery in our center between January 2002 and December 2018. Pre-operative, peri-operative, and post-operative data were recorded for statistical analysis.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Thirty patients with overflow fecal incontinence after initial megacolon surgery [17 who underwent transanal pull-through (TA-PT) and 13 who underwent laparoscopic-assisted pull-through (LA-PT)] required a secondary surgery [reoperation with LA-PT (LAR-PT) (<jats:italic>n<\/jats:italic> = 16) or reoperation with transabdominal pull-through (TR-PT) (<jats:italic>n<\/jats:italic> = 14)]. Indications for reoperation were residual aganglionosis (RA) (7\/30, 23.3%) or transition zone pathology (TZP) (23\/17, 76.7%). Blood loss was significantly decreased in the LAR-PT group (75 \u00b1 29.2 ml) compared to the TR-PT group (190 \u00b1 51.4 ml) (<jats:italic>P<\/jats:italic> = 0.001). The length of hospital stay was significantly shorter in the LAR-PT group (10 \u00b1 1.5 days) than that in the TR-PT group (13 \u00b1 2.4 days). No significant differences were found between two groups in surgical methods, defecation function score, or post-operative complications except for wound infection (LAR-PT vs. TR-PT 0 vs. 28.6%, <jats:italic>P<\/jats:italic> &amp;lt; 0.05).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> It is necessary to make a comprehensive analysis of the causes of fecal incontinence after HSCR surgery and make an accurate judgment using appropriate methods. If a reoperation was inevitable for patients with overflow fecal incontinence due to RA or TZP, a comprehensive evaluation prior to the operation is required to maximize the benefit from reoperation. Although laparoscopic reoperation with heart-shaped anastomosis was safe and feasible for patients with failed initial Soave technique, unnecessary reoperation should be avoided as much as possible.<\/jats:p>","DOI":"10.3389\/fped.2021.600316","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T07:46:37Z","timestamp":1619595997000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Laparoscopic vs. Transabdominal Treatment for Overflow Fecal Incontinence Due to Residual Aganglionosis or Transition Zone Pathology in Hirschsprung's Disease 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