This systematic review assessed the safety and efficacy of the disposable circumcision suture device （DCSD） and conventional circumcision （CC） in the treatment of redundant prepuce and phimosis. Two independent re...This systematic review assessed the safety and efficacy of the disposable circumcision suture device （DCSD） and conventional circumcision （CC） in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials （RCTs） using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs （1898 cases） were included. Compared with the CC group, the DCSD group had a shorter operative time （standardized mean difference [SMD] = -21.44; 95% confidence intervals [95% CIs] [-25.08, -17.79]; P 〈 0.00001）, shorter wound healing time （SMD = -3.66; 95% CI [-5.46, -1.85]; P 〈 0.0001）, less intraoperative blood loss （SMD = -9.64; 95% CI [-11.37, -7.90]; P 〈 0.00001）, better cosmetic penile appearance （odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P 〈 0.00001）, lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed.展开更多
目的总结一次性包皮环切缝合器、经典式及袖套式包皮环切术的经验,比较三种包皮环切术式的各自特点。方法回顾性分析于2014年7月至2016年7月期间在我院行包皮环切术(应用一次性包皮环切缝合器、经典式及袖套式包皮环切术分别为112例、12...目的总结一次性包皮环切缝合器、经典式及袖套式包皮环切术的经验,比较三种包皮环切术式的各自特点。方法回顾性分析于2014年7月至2016年7月期间在我院行包皮环切术(应用一次性包皮环切缝合器、经典式及袖套式包皮环切术分别为112例、123例及108例)患者的临床资料,比较三种术式手术时间、术中出血量、疼痛评分、术后并发症发生率、阴茎外观满意率等指标。分析三种手术各自特点和经验总结。结果应用一次性包皮环切缝合器、经典式及袖套式包皮环切术手术时间分别为5.6±3.5 min、25.6±6.7 min及34.3±5.4 min(P<0.001),术中出血量分别为2.0±0.7 m L、12.3±5.8 m及4.1±2.3 m L(P<0.001),术后24 h疼痛评分分别为3.1±1.1分、5.4±1.2分及3.5±0.9分(P<0.001),术后并发症发生率分别为9.8%(11/112)、16.3%(20/123)及11.1%(12/108)(P=0.286),术后阴茎外观满意度分别为97.3%(109/112)、85.4%(105/123)及95.4%(103/108)(P=0.001)。以上数据比较,差异均有统计学意义。结论三组手术方式各有优缺点,应用一次性包皮环切缝合器操作简单、手术时间短、术中出血量少、术后阴茎外观满意率高,但费用偏高;而袖套式包皮环切术相对于经典式包皮环切术手术时间稍长,但术中出血量明显减少、术后疼痛评分低且阴茎外观满意度较高,因此,对于青春期男性及成人患者可考虑推荐袖套式包皮环切术。展开更多
Male circumcision is one of the most commonly performed operations worldwide, and many novel techniques have been developed for better postoperative outcomes. The purpose of this study was to explore the feasibility o...Male circumcision is one of the most commonly performed operations worldwide, and many novel techniques have been developed for better postoperative outcomes. The purpose of this study was to explore the feasibility of applying the ultracision harmonic scalpel （UHS） for circumcision by using dogs. Sixteen adult male dogs were divided into two groups： the UHS group and the control group. The dogs were circumcised with either the UHS or a conventional scalpel. The UHS circumcision procedure and the effects were imaged 1 week after surgery. The two groups were compared with respect to the operative time and volume of blood loss. Postoperative complications, including oedema, infection, bleeding of the incision and wound dehiscence, were recorded for both groups. The mean operative time for the UHS group was only 5.1 min compared with the 35.5 min of the conventional group. The mean blood loss was less than 2 ml for the UHS group and 15 ml for the conventional group. There was only one case of mild oedema in the UHS group, but the postoperative complications in the conventional group included two cases of mild oedema, one infection of the incision and one Case of bleeding of the incision. In conclusion, circumcision using UHS is a novel technique to treat patients with phimosis and excessive foreskin, and this method has a short operative time, less blood loss and fewer complications than the conventional scalpel method. This small animal study orovides a basis for embarking on a larger-scale clinical trial of the UHS.展开更多
目的与传统包皮环切术(CC)相比,一次性包皮环切缝合器(DCSD)在包皮环切术中的疗效观察。方法选择我院2013年7月~2014年2月的82例患者,根据患者的意愿,分别用一次性包皮环切缝合器和传统的方法行包皮环切术。一次性包皮环切缝合器40例,...目的与传统包皮环切术(CC)相比,一次性包皮环切缝合器(DCSD)在包皮环切术中的疗效观察。方法选择我院2013年7月~2014年2月的82例患者,根据患者的意愿,分别用一次性包皮环切缝合器和传统的方法行包皮环切术。一次性包皮环切缝合器40例,传统方法42例。分别在手术时间,术中失血量,伤口愈合时间,术后并发症及患者对术后阴茎外观的满意度方面进行比较观察。结果与传统的包皮环切术相比,一次性包皮环切缝合器在手术持续时间[DCSD 组(6.8±1.8) min vs. CC组(25.4±4.5) min],术中出血量[DCSD组(1.2±0.5) mL vs. CC组(9.5±1.5) mL]方面占有明显优势;在伤口愈合时间[DCSD 组(14.9±1.9) d vs. CC组(15.4±2.1)d]和术后并发症(6.8%vs7.1%)方面无明显差异(>0.05);一次性包皮环切缝合器术后患者的满意率高(97.7%vs.78.6%)。结论与传统的包皮环切术相比,一次性包皮环切缝合器是一种创新,手术简单,安全,手术时间短,术中出血量少,并发症少,切割与缝合一次完成,术后伤口整齐,外形美观。即使患者感到满意,又提高了医生的工作效率。值得重视和推广。展开更多
文摘This systematic review assessed the safety and efficacy of the disposable circumcision suture device （DCSD） and conventional circumcision （CC） in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials （RCTs） using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs （1898 cases） were included. Compared with the CC group, the DCSD group had a shorter operative time （standardized mean difference [SMD] = -21.44; 95% confidence intervals [95% CIs] [-25.08, -17.79]; P 〈 0.00001）, shorter wound healing time （SMD = -3.66; 95% CI [-5.46, -1.85]; P 〈 0.0001）, less intraoperative blood loss （SMD = -9.64; 95% CI [-11.37, -7.90]; P 〈 0.00001）, better cosmetic penile appearance （odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P 〈 0.00001）, lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed.
文摘目的总结一次性包皮环切缝合器、经典式及袖套式包皮环切术的经验,比较三种包皮环切术式的各自特点。方法回顾性分析于2014年7月至2016年7月期间在我院行包皮环切术(应用一次性包皮环切缝合器、经典式及袖套式包皮环切术分别为112例、123例及108例)患者的临床资料,比较三种术式手术时间、术中出血量、疼痛评分、术后并发症发生率、阴茎外观满意率等指标。分析三种手术各自特点和经验总结。结果应用一次性包皮环切缝合器、经典式及袖套式包皮环切术手术时间分别为5.6±3.5 min、25.6±6.7 min及34.3±5.4 min(P<0.001),术中出血量分别为2.0±0.7 m L、12.3±5.8 m及4.1±2.3 m L(P<0.001),术后24 h疼痛评分分别为3.1±1.1分、5.4±1.2分及3.5±0.9分(P<0.001),术后并发症发生率分别为9.8%(11/112)、16.3%(20/123)及11.1%(12/108)(P=0.286),术后阴茎外观满意度分别为97.3%(109/112)、85.4%(105/123)及95.4%(103/108)(P=0.001)。以上数据比较,差异均有统计学意义。结论三组手术方式各有优缺点,应用一次性包皮环切缝合器操作简单、手术时间短、术中出血量少、术后阴茎外观满意率高,但费用偏高;而袖套式包皮环切术相对于经典式包皮环切术手术时间稍长,但术中出血量明显减少、术后疼痛评分低且阴茎外观满意度较高,因此,对于青春期男性及成人患者可考虑推荐袖套式包皮环切术。
文摘Male circumcision is one of the most commonly performed operations worldwide, and many novel techniques have been developed for better postoperative outcomes. The purpose of this study was to explore the feasibility of applying the ultracision harmonic scalpel （UHS） for circumcision by using dogs. Sixteen adult male dogs were divided into two groups： the UHS group and the control group. The dogs were circumcised with either the UHS or a conventional scalpel. The UHS circumcision procedure and the effects were imaged 1 week after surgery. The two groups were compared with respect to the operative time and volume of blood loss. Postoperative complications, including oedema, infection, bleeding of the incision and wound dehiscence, were recorded for both groups. The mean operative time for the UHS group was only 5.1 min compared with the 35.5 min of the conventional group. The mean blood loss was less than 2 ml for the UHS group and 15 ml for the conventional group. There was only one case of mild oedema in the UHS group, but the postoperative complications in the conventional group included two cases of mild oedema, one infection of the incision and one Case of bleeding of the incision. In conclusion, circumcision using UHS is a novel technique to treat patients with phimosis and excessive foreskin, and this method has a short operative time, less blood loss and fewer complications than the conventional scalpel method. This small animal study orovides a basis for embarking on a larger-scale clinical trial of the UHS.
文摘目的与传统包皮环切术(CC)相比,一次性包皮环切缝合器(DCSD)在包皮环切术中的疗效观察。方法选择我院2013年7月~2014年2月的82例患者,根据患者的意愿,分别用一次性包皮环切缝合器和传统的方法行包皮环切术。一次性包皮环切缝合器40例,传统方法42例。分别在手术时间,术中失血量,伤口愈合时间,术后并发症及患者对术后阴茎外观的满意度方面进行比较观察。结果与传统的包皮环切术相比,一次性包皮环切缝合器在手术持续时间[DCSD 组(6.8±1.8) min vs. CC组(25.4±4.5) min],术中出血量[DCSD组(1.2±0.5) mL vs. CC组(9.5±1.5) mL]方面占有明显优势;在伤口愈合时间[DCSD 组(14.9±1.9) d vs. CC组(15.4±2.1)d]和术后并发症(6.8%vs7.1%)方面无明显差异(>0.05);一次性包皮环切缝合器术后患者的满意率高(97.7%vs.78.6%)。结论与传统的包皮环切术相比,一次性包皮环切缝合器是一种创新,手术简单,安全,手术时间短,术中出血量少,并发症少,切割与缝合一次完成,术后伤口整齐,外形美观。即使患者感到满意,又提高了医生的工作效率。值得重视和推广。
