Corona C, Cañizo A, Cerda J, Fanjul M, Carrera N, Tardáguila A, Zornoza M, Parente A, Angulo J M, De Tomás E, Molina E, Peláez D, García Casillas M A, Rivas S, Romero R, Marín M C
Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid.
Cir Pediatr. 2011 Jan;24(1):51-4.
Phimosis is perhaps one of the most frequent consultation on pediatric surgery clinics throught the world. The aim of this study is to compare the two procedures more frequently performed in our hospital: dorsal slit and circumcision. PATIENTS Y METHODS: Retrospective study of 1698 patients who were admitted for elective surgical treatment of phimosis between 2003 and 2009. We analyzed age, surgical and anesthethic times, surgical technique and complications. We also did transversal descriptive study through telephonic survey on parents and patients older than 16 years old.
There was 76.6% of dorsal slit (n = 1300) and 23.4% (n= 398) of circumcisions. Mean age was 7.15 years y mean time of follow up was 42.3 months. Surgical time was significantly higher in circumcision (p < 0.0001). There were 3% (n = 51) of reoperations, no differences between groups. We didn't find differences in postoperative stenosis, but bleeding was more frequent in circumcision group (1.7%; p = 0.03). There were no differences on parental appreciation of postoperative pain, or functional and esthetic satisfaction between groups.
We didn't find differences on subjective satisfaction between groups. Even if there are differences n postoperative bleeding, global incidence is very low. In our experience both techniques are valid and safe, so surgeon and parents must jointly make the decision.
包茎可能是全球儿科外科诊所最常见的就诊问题之一。本研究的目的是比较我院最常施行的两种手术:背侧切开术和包皮环切术。
对2003年至2009年间因择期手术治疗包茎而入院的1698例患者进行回顾性研究。我们分析了年龄、手术时间和麻醉时间、手术技术及并发症。我们还通过电话调查对16岁以上的家长和患者进行了横断面描述性研究。
背侧切开术占76.6%(n = 1300),包皮环切术占23.4%(n = 398)。平均年龄为7.15岁,平均随访时间为42.3个月。包皮环切术的手术时间明显更长(p < 0.0001)。再次手术率为3%(n = 51),两组之间无差异。我们未发现术后狭窄方面的差异,但包皮环切术组出血更频繁(1.7%;p = 0.03)。两组在家长对术后疼痛的评价、功能和美学满意度方面均无差异。
我们未发现两组在主观满意度上存在差异。即使术后出血存在差异,但总体发生率很低。根据我们的经验,两种技术都是有效且安全的,因此外科医生和家长必须共同做出决定。