To evaluate the feasibility and effectiveness of single-port laparoscopic surgery in two-stage surgery for long-segment Hirschsprung disease in children, as well as its benefits and drawbacks.

14 children with long-segment Hirschsprung disease unsuitable for primary radical operation were treated by two-stage single-port laparoscopic operations in the Gastrointestinal Surgery Department of Guangzhou Women and Children′s Medical Center from Jun. 2018 to Jun. 2021, including 11 males and 3 females; aged from 1 to 6 months; the clinical data were retrospectively collected and analyzed. All 14 patients underwent staging operations: the first stage operation was single-port laparoscopic colostomy and intestinal wall biopsy, the second stage operation was performed after 3 months, and all cases accepted single-port laparoscopic endorectal pull-through approach: Swenson-like + Deloyers reversion. The postoperative follow-up of these children ranged from 18 to 54 months.

All 14 patients successfully completed two-stage operations as planned without additional trocars or conversion to open surgery. The second stage of the mean operation time was(156±21)minutes, and the intraoperative blood loss was(5±2)mL. The average length of the resected intestine was (40±8)cm. The average time to recovery of intestinal function was (9±4) hours. The average hospital stay was (6±2)days. The average postoperative pain score was(3±1)points. All of them had voluntarily defecated. The main complications were skin flushing (28.57%), enterocolitis (14.29%) and soiling (7.14%). The length of postoperative incision scar ranged from 2 cm to 2.5 cm, whose appearance was fairly good. There were no other complications including bleeding, intestinal obstruction, anastomotic leakage, recurrence of constipation, and fecal incontinence.

Application of single-port laparoscopic surgery, including one-stage colostomy and an intestinal wall biopsy combined with second-stage single-port laparoscopic endorectal pull-through approach can be performed safely and feasibly in children with long-segment Hirschsprung disease unsuitable for one-stage operation. The short-term and mid-term postoperative results, as well as the cosmetic outcome, were relatively satisfactory.