Farshi Z, Atkinson K R, Squire R
Department of Clinical Effectiveness and Department of Paediatric Surgery, St James's University Hospital, Leeds LS9 7TF, UK.
Arch Dis Child. 2000 Nov;83(5):393-6. doi: 10.1136/adc.83.5.393.
To establish clinical opinion regarding appropriate indications for circumcision and to examine actual clinical practice.
A questionnaire was sent to all NHS hospital consultants in the Yorkshire region of the UK identified as having a role to play in the management of boys (under 16 years of age) requiring circumcision. Retrospective data on actual clinical practice during a three month study period were also collected via a simple proforma.
Of 153 questionnaires sent, 64 were returned. Responses revealed varying opinions regarding appropriate indications for circumcision within each consultant group, and between paediatricians and surgeons. Surgeons were generally more inclined to recommend circumcision for each of the indications listed in the questionnaire. Analysis of clinical practice revealed that almost two thirds of procedures were carried out for phimosis, and nearly half of these children were under the age of 5 years.
There are differences in the clinical opinions of surgeons and paediatricians on what constitutes an appropriate indication for circumcision. Paediatricians' opinions are generally more in line with current evidence than those of surgeons, possibly resulting in many unnecessary circumcisions.
确立关于包皮环切术合适指征的临床观点，并审视实际临床操作情况。
向英国约克郡地区所有被认定在处理（16岁以下）需要包皮环切术的男孩时发挥作用的国民健康服务体系（NHS）医院顾问发送问卷。还通过一份简单表格收集了为期三个月研究期间实际临床操作的回顾性数据。
在发出的153份问卷中，64份被退回。回复显示，每个顾问组内部以及儿科医生和外科医生之间对于包皮环切术合适指征的观点各不相同。对于问卷中列出的各项指征，外科医生总体上更倾向于推荐进行包皮环切术。临床操作分析显示，几乎三分之二的手术是因包茎进行的，其中近一半儿童年龄在5岁以下。
外科医生和儿科医生对于什么构成包皮环切术的合适指征的临床观点存在差异。儿科医生的观点总体上比外科医生的观点更符合当前证据，这可能导致许多不必要的包皮环切术。
