新生儿包皮环切术的远期并发症:一个常见且可避免的问题。
Late complications of newborn circumcision: a common and avoidable problem.
作者信息
Pieretti Rafael V, Goldstein Allan M, Pieretti-Vanmarcke Rafael
机构信息
Section of Pediatric Urology, Massachusetts General Hospital, Boston, USA.
出版信息
Pediatr Surg Int. 2010 May;26(5):515-8. doi: 10.1007/s00383-010-2566-9. Epub 2010 Feb 14.
PURPOSE
The purpose of this paper is to study the types of operative and post-operative late complications resulting from newborn circumcisions and to make recommendations to prevent them.
METHODS
After obtaining IRB approval, a retrospective review of the late complications resulting from newborn circumcisions treated at the MassGeneral Hospital for Children from January 2003 to December 2007 was undertaken. The source used was the consultation notes and operative reports of affected patients. Additionally, cases seen in the outpatient Pediatric Urology Clinic from April 2007 to April 2008 were reviewed.
RESULTS
A total of 8,967 children were operated during the study period, of which 424 (4.7%) were for complications resulting from previous neonatal circumcision. Penile adhesions, skin bridges, meatal stenosis, redundant foreskin (incomplete circumcision with uncircumcised appearance), recurrent phimosis, buried penis and penile rotation were the most frequent complications. At the outpatient clinic of the Section of Pediatric Urology, 127 boys with concerns following newborn circumcision were evaluated, representing 7.4% of the total volume of cases seen in this clinic.
CONCLUSIONS
Our results indicate the need to undertake a collaborative study to define the incidence of complications following newborn circumcisions, which should be performed by practitioners with adequate training in the technique of their choice and its post-operative care.
目的
本文旨在研究新生儿包皮环切术后的手术及术后晚期并发症类型,并提出预防建议。
方法
在获得机构审查委员会(IRB)批准后,对2003年1月至2007年12月在麻省总医院儿童医院接受治疗的新生儿包皮环切术后晚期并发症进行回顾性研究。使用的资料来源是受影响患者的会诊记录和手术报告。此外,还对2007年4月至2008年4月在儿科泌尿外科门诊所见病例进行了回顾。
结果
在研究期间,共有8967名儿童接受了手术,其中424名(4.7%)是因先前新生儿包皮环切术的并发症而接受手术。阴茎粘连、皮肤桥、尿道口狭窄、包皮过长(外观呈未环切状的不完全包皮环切)、复发性包茎、埋藏阴茎和阴茎旋转是最常见的并发症。在儿科泌尿外科门诊,对127名新生儿包皮环切术后有问题的男孩进行了评估,占该门诊所见病例总数的7.4%。
结论
我们的结果表明,需要开展一项合作研究来确定新生儿包皮环切术后并发症的发生率,手术应由在所选技术及其术后护理方面接受过充分培训的从业者进行。