Lü Nian-qing, Li Philip S, Sokal David, Cheng Yue, Peng Yi-feng, Barone Mark, Huang Yi-ran, Goldstein Marc
Jiangsu Family Planning Research Institute, Nanjing, Jiangsu 210036, China.
Zhonghua Nan Ke Xue. 2011 Mar;17(3):195-202.
Male circumcision can reduce men's risk of HIV infection from heterosexual intercourse by 60% and is therefore recommended as an important strategy for HIV prevention in Africa by WHO and UNAIDS. However, rapid expansion of male circumcision efforts could be greatly facilitated by a safer, more effective and acceptable male circumcision surgical technique or device. Shang Ring is a simple technique developed in China. It allows a circumcision to be completed with minimal bleeding, without suturing, and in only 3-5 min and reported complications are few. A standardized adult male circumcision surgical protocol utilizing the Shang Ring device was developed in 2008 in China. Several surgical training courses using this protocol were successfully held in 2009 and 2010 in China. A recent pilot clinical study of the Shang Ring was conducted to evaluate its safety and efficiency in Kenya in 2009. The results and acceptability among study participants were excellent and confirmed many of the advantages seen in the earlier Chinese studies from Wuhu, Ningbo and Xi'an, suggesting that the Shang Ring is safe for further studies in Africa, thus, could facilitate more rapid roll-out of adult male circumcision through task shifting, surgical efficiencies and better acceptability. Further international investigations of the Shang Ring technique have now been planned for Kenya and Zambia in 2011. Moreover, adult male circumcision utilizing the Shang Ring device is now being considered as ope of the potential candidate techniques to be used in the scale-up of adult male circumcision services for HIV prevention in WHO priority countries in Africa. This review article summarizes Shang Ring related clinical studies, seminars and surgical workshops, publications and presentations conducted between February 2008 and December 2010 in China, the United States and Africa.
男性包皮环切术可将男性通过异性性行为感染艾滋病毒的风险降低60%，因此世界卫生组织和联合国艾滋病规划署推荐其作为非洲预防艾滋病毒的一项重要策略。然而，一种更安全、更有效且更易接受的男性包皮环切手术技术或器械能够极大地推动包皮环切工作的迅速开展。商环是中国研发的一项简易技术。它能在出血极少、无需缝合的情况下，仅用3至5分钟完成包皮环切手术，且报告的并发症很少。2008年中国制定了使用商环器械的标准化成年男性包皮环切手术方案。2009年和2010年在中国成功举办了数次采用该方案的手术培训课程。2009年在肯尼亚对商环进行了一项初步临床研究，以评估其安全性和有效性。研究参与者的结果及接受度都非常好，证实了早期在中国芜湖、宁波和西安开展的研究所发现的诸多优点，这表明商环在非洲进行进一步研究是安全的，因此，通过任务转移、手术效率提高和更好的接受度，能够推动成年男性包皮环切术更快地推广。现已计划2011年在肯尼亚和赞比亚对商环技术展开进一步的国际调查。此外，利用商环器械进行成年男性包皮环切术目前正被视为可能用于扩大非洲世卫组织重点国家预防艾滋病毒成年男性包皮环切服务规模的潜在候选技术之一。这篇综述文章总结了2008年2月至2010年12月期间在中国、美国和非洲开展的与商环相关的临床研究、研讨会、手术工作坊、出版物及报告。
