Alanis Mark C, Lucidi Richard S
Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, North Carolina, USA.
Obstet Gynecol Surv. 2004 May;59(5):379-95. doi: 10.1097/00006254-200405000-00026.
Untimely old, circumcision has elicited more controversy and war of words than any surgical procedure in history. Although previous claims of benefits like curing masturbation, gout, epilepsy, and even insanity were no doubt absurd, important research has shed light on real medical benefits of circumcision. In particular, the procedure has consistently shown to result in the decreased risk of debilitating and costly diseases such as HIV, cervical cancer, and infantile urinary tract infection. Because of advances in the understanding of the anatomy of the foreskin and pain conditioning in infants, prevailing attitudes have changed about anesthesia and analgesia during the procedure. This article objectively summarizes the bulk of significant medical literature over the last century to provide an accurate statement about what we know and what we do not know about neonatal circumcision, including its history, epidemiology, medical benefits, complications, contraindications, techniques, management for pain, and current controversies.
Obstetricians & Gynecologists, Family Physicians.
After completion of this article, the reader should be able to describe the evolution of circumcision, to list the potential benefits of circumcision, to outline the various neonatal circumcision techniques, and to summarize the data on the use of analgesia for circumcision.
不合时宜地过时了，包皮环切术引发的争议和口舌之争比历史上任何外科手术都要多。尽管先前声称包皮环切术有诸如治愈手淫、痛风、癫痫甚至精神错乱等益处无疑是荒谬的，但重要的研究已揭示了包皮环切术真正的医学益处。特别是，该手术一直显示出能降低感染艾滋病病毒、宫颈癌和婴幼儿尿路感染等使人虚弱且费用高昂的疾病的风险。由于在包皮解剖学和婴儿疼痛调节方面的认识进展，人们对该手术期间的麻醉和镇痛的普遍态度已经改变。本文客观地总结了过去一个世纪大量重要的医学文献，以准确阐述我们对新生儿包皮环切术已知和未知的情况，包括其历史、流行病学、医学益处、并发症、禁忌症、技术、疼痛管理以及当前的争议。
妇产科医生、家庭医生。
阅读本文后，读者应能够描述包皮环切术的演变过程，列出包皮环切术的潜在益处，概述各种新生儿包皮环切术技术，并总结包皮环切术镇痛使用的数据。
