Robotic surgery in Hirschsprung disease: a unicentric experience on 31 procedures.

Robotic surgery has been increasingly applied to Hirschsprung patients with encouraging results. We report the results of a 5 year unicentric experience. All consecutive HSCR patients older than 12 months who underwent a surgical procedure with robotic approach between September 2017 and August 2022 were prospectively included. We collected data regarding demographics, extent of aganglionosis, associated anomalies, indications to surgery, and a number of perioperative data such as surgical details, intraoperative and perioperative complications, length of surgery, length of hospital stay, and functional outcome. A total of 28 patients underwent 31 robotic procedures during the study period. Median age at surgery was 82 months. Eleven primary Totally Robotic Soave Pull-Through, 12 redoes, 5 innervative mapping, 2 redundant rectal pouch excision, and 1 Miles' procedures have been performed. Median console time was 145 min. No conversion to either laparoscopy nor to laparotomy was required. Median length of hospital stay was 6 days. Two patients experienced complications requiring reiterative surgery. One patient experienced mild postoperative enterocolitis. Normal continence was achieved by 70% of patients after a median of 16 months postoperatively (80% for primary pull-throughs, 55% for redoes). To conclude, robotic surgery for older HSCR patients proved to be feasible, safe, and effective. Patients with complex surgical requirements seem to benefit most from this promising approach. Provided the economic burden is addressed and solved, robotic surgery will represent an excellent alternative for the surgical treatment of HSCR patients.

Gender specific data in patients with acute appendicitis: a single center perspective.

BACKGROUND: The influence of sex, socioeconomic status and other factors on outcomes from acute illness has been found recently with an increasing interest; acute appendicitis is the most frequent urgency in pediatric age. The aim of this study is to show any gender differences. MATERIALS AND METHODS: We retrospectively analysed the medical records of consecutive patients who underwent surgical exploration for acute appendicitis. Inclusion and exclusion criteria were created. Patient data, demographics, characteristics and outcomes were studied and evaluated on a gender perspective. RESULTS: After reviewing medical charts following the inclusion and exclusion criteria, 364 patients were studied; focusing on final outcomes, it was possible to add news from a gender perspective of appendicitis: gangrenous appendicitis was associated with younger female and older female were more likely to have false positive appendicitis; female had less post-operative pain respect to agematch male for all appendicitis and males had more symptoms respect to females especially for phlegmonous and gangrenous appendicitis. CONCLUSIONS: There is a gender difference in appendicitis; as for adults girls appear to be affected less, have fewer symptoms and have better postoperative results.