Méndez-Gallart Roberto, Estévez Elina, Bautista Adolfo, Rodríguez Pablo, Taboada Pedro, Armas Azucena L, Pradillos Jose M, Varela Ramiro
Department of Pediatric Surgery, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain.
J Pediatr Surg. 2009 Oct;44(10):2048-53. doi: 10.1016/j.jpedsurg.2009.06.008.
The aim of this study is to evaluate bipolar scissors circumcision by comparing it with standard freehand scalpel procedure.
Data were analyzed from a prospective, randomized study, comparing 2 different surgical techniques for pediatric circumcision: the bipolar diathermy scissors circumcision technique with those of a conventional scalpel technique. A total of 230 pediatric patients younger than 16 years (115 in each arm of the trial) who were undergoing circumcision were reviewed prospectively. Operative time, surgical bleeding, complications, and postoperative morbidity were analyzed. Differences between bipolar scissors circumcision and conventional surgery were compared.
Median blood loss for bipolar circumcision was 0.2 mL (range, 0-0.8 mL) compared with 2.1 mL in the standard group (range, 0.9-4.2 mL) (P < .001). Operative time in the bipolar diathermy treated group was significantly decreased compared with conventionally treated patients (10.8 +/- 1.2 vs 19.1 +/- 2.6 minutes; P < .01). Early and late postoperative morbidity were significantly decreased in circumcised patients who underwent the bipolar circumcision technique as compared with those who underwent the conventional approach regardless of the postoperative edema (22 vs 10; P = .02).
Bipolar scissors circumcision approach is an effective and safe procedure alternative to the standard scalpel technique in pediatric circumcision with no significant morbidity.
本研究旨在通过将双极电凝剪刀包皮环切术与标准徒手手术刀手术进行比较,来评估该手术方法。
对一项前瞻性随机研究的数据进行分析,比较两种不同的小儿包皮环切手术技术:双极电凝剪刀包皮环切技术与传统手术刀技术。前瞻性地回顾了总共230例年龄小于16岁的接受包皮环切术的小儿患者(试验每组各115例)。分析手术时间、手术出血、并发症及术后发病率。比较双极电凝剪刀包皮环切术与传统手术之间的差异。
双极电凝包皮环切术的中位失血量为0.2毫升(范围0 - 0.8毫升),而标准组为2.1毫升(范围0.9 - 4.2毫升)(P < 0.001)。与传统治疗患者相比,双极电凝治疗组的手术时间显著缩短(10.8 ± 1.2对19.1 ± 2.6分钟;P < 0.01)。与采用传统方法的患者相比,接受双极电凝包皮环切术的患者无论术后有无水肿,早期和晚期术后发病率均显著降低(22对10;P = 0.02)。
在小儿包皮环切术中,双极电凝剪刀包皮环切术是一种有效且安全的手术方法,可替代标准手术刀技术,且发病率无显著差异。