Mungnirandr Akkrapol, Wiriyakamolphan Suwanna, Ruangtrakool Ravit, Ngerncham Monawat, Tumrongsombutsakul Sureerat, Leumcharoen Bungorn
Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Perioperative Nursing Division, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Lasers Med Sci. 2015 Winter;6(1):28-37.
CO2 (Carbon Dioxide) laser application in circumcision, for cutting and coagulation, has been reported to have excellent results. Also, tissue glue has been reported to have advantages over sutures for approximation of wound edges. Most previous studies focused on comparisons between CO2 laser and scalpel, or between tissue glue and sutures. This study prospectively compared the results and complications CO2 laser and tissue glue, with standard surgical techniques in circumcision.
Thirty boys were prospectively divided into two groups. Group 1 (n = 17) underwent circumcision by scalpel with approximation of the wound edges using chromic catgut sutures. Group 2 (n = 13) underwent circumcision with CO2 laser and approximation of the wound edges using tissue glue. Patient age, indications for surgery, operative time, wound swelling, bleeding, wound infection, local irritation, pain score, and cosmetic appearance were recorded.
Group 1 had a significantly longer operative time (P= 0.011), higher rate of local irritation (P= 0.016), and poorer cosmetic appearance (P< 0.001) than group 2. Bleeding only occurred in one patient in group 1. There were no significant differences in pain score, wound infection rate, or cost of surgery between the two groups.
CO2 laser and tissue glue have advantages over standard surgical techniques in circumcision, with a significantly shorter operative time, lower rate of local irritation, and better cosmetic appearance. The cost of surgery is similar between the two groups.
据报道，二氧化碳（CO2）激光应用于包皮环切术的切割和凝血，效果极佳。此外，据报道，在伤口边缘对合方面，组织胶水比缝线具有优势。以往大多数研究集中在CO2激光与手术刀之间，或组织胶水与缝线之间的比较。本研究前瞻性地比较了CO2激光和组织胶水与包皮环切术标准手术技术的效果及并发症。
30名男孩被前瞻性地分为两组。第1组（n = 17）采用手术刀进行包皮环切术，并用铬制肠线缝合伤口边缘。第2组（n = 13）采用CO2激光进行包皮环切术，并用组织胶水对合伤口边缘。记录患者年龄、手术指征、手术时间、伤口肿胀、出血、伤口感染、局部刺激、疼痛评分和外观。
与第2组相比，第1组的手术时间明显更长（P = 0.011），局部刺激发生率更高（P = 0.016），外观更差（P < 0.001）。第1组仅1例患者发生出血。两组在疼痛评分、伤口感染率或手术费用方面无显著差异。
在包皮环切术中，CO2激光和组织胶水比标准手术技术具有优势，手术时间明显更短，局部刺激发生率更低，外观更好。两组手术费用相似。
