Yang Ben-Hai, Jia Chao, Liu Tao, Peng Yi-Feng
Zhonghua Nan Ke Xue. 2014 Aug;20(8):709-14.
To evaluate the safety and clinical outcomes of the novel simplified no-flip surgical approach to Shang Ring male circumcision in adults.
A total of 528 adult males, aged 18 - 58 (mean 35) years, 63 with phimosis and 465 with redundant prepuce, underwent no-flip Shang Ring circumcision with or without removal of the outer ring. The operation time and intraoperative blood loss were recorded and observations were made on such complications as postoperative bleeding, infection, edema, and wound dehiscence.
The operation time, intraoperative blood loss, and 2-hour postoperative pain score were (3.8 +/- 0.3) min, (0.6 +/- 0.1) ml, and 7.3 +/-0.3, respectively. Spontaneous ring detachment occurred at 21.6 +/- 2.1 days postoperatively in 12.7% of the patients (67/528) who had chosen not to remove the rings. Of those who preferred removal of the outer ring (87.3% [461/528]), none experienced any pain at the ring removal 7 days after the operation. Postoperative complications included infection in 3 cases (0.56%) and mild edema in 9 (1.70%), but no bleeding and wound dehiscence. Totally, 518 (98.1%) of the patients felt satisfied with the postoperative penile appearance.
No-flip Shang Ring circumcision, with no need for removal of the inner ring, is a safe and simple approach for adult males, which is superior to conventional Shang Ring circumcision for requirement of fewer surgical instruments, shorter operation time, lower incidence of complications, and better satisfaction with the penile appearance. However, these advantages are to be further demonstrated by more randomized controlled trials.
评估新型简化免翻转手术方式用于成人商环包皮环切术的安全性及临床效果。
共有528例年龄在18至58岁（平均35岁）的成年男性接受了免翻转商环包皮环切术，其中63例患有包茎，465例包皮过长，部分患者切除外环，部分未切除。记录手术时间及术中出血量，并观察术后出血、感染、水肿及伤口裂开等并发症情况。
手术时间、术中出血量及术后2小时疼痛评分分别为（3.8±0.3）分钟、（0.6±0.1）毫升和7.3±0.3。12.7%（67/528）选择不切除外环的患者术后21.6±2.1天出现外环自行脱落。选择切除外环的患者（87.3%[461/528]）术后7天拆除外环时均无疼痛。术后并发症包括3例感染（0.56%）和9例轻度水肿（1.70%），无出血及伤口裂开。总体而言，518例（98.1%）患者对术后阴茎外观满意。
免翻转商环包皮环切术无需切除内环，对成年男性来说是一种安全、简便的方法，与传统商环包皮环切术相比，所需手术器械更少、手术时间更短、并发症发生率更低，患者对阴茎外观满意度更高。然而，这些优势有待更多随机对照试验进一步证实。
