Huo Zhong-Chao, Liu Gang, Li Xiao-Yan, Liu Fei, Fan Wen-Ju, Guan Ru-Hua, Li Pei-Feng, Mo De-Yang, He Yong-Zhi
Department of Urology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, China.
Graduate School, Guangxi University of Traditional Chinese Medicine, Nanning 530200, Guangxi, China.
Asian J Androl. 2017 May-Jun;19(3):362-367. doi: 10.4103/1008-682X.174855.
This systematic review assessed the safety and efficacy of the disposable circumcision suture device (DCSD) and conventional circumcision (CC) in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials (RCTs) using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs (1898 cases) were included. Compared with the CC group, the DCSD group had a shorter operative time (standardized mean difference [SMD] = -21.44; 95% confidence intervals [95% CIs] [-25.08, -17.79]; P < 0.00001), shorter wound healing time (SMD = -3.66; 95% CI [-5.46, -1.85]; P < 0.0001), less intraoperative blood loss (SMD = -9.64; 95% CI [-11.37, -7.90]; P < 0.00001), better cosmetic penile appearance (odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P < 0.00001), lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed.
本系统评价评估了一次性包皮环切缝合器(DCSD)与传统包皮环切术(CC)治疗包皮过长和包茎的安全性和有效性。两名独立评价者检索了国内外使用DCSD和CC治疗包皮过长或包茎的随机对照试验(RCT)。纳入9项RCT(1898例)。与CC组相比,DCSD组手术时间更短(标准化均数差[SMD]=-21.44;95%置信区间[95%CI][-25.08,-17.79];P<0.00001),伤口愈合时间更短(SMD=-3.66;95%CI[-5.46,-1.85];P<0.0001),术中出血量更少(SMD=-9.64;95%CI[-11.37,-7.90];P<0.00001),阴茎外观美容效果更好(优势比[OR]=8.77;95%CI[5.90,13.02];P<0.00001),术中疼痛评分更低,术后24小时疼痛评分更低,感染发生率更低,切口水肿更少,不良事件更少。CC组和DCSD组在裂开或血肿发生率方面无差异。该荟萃分析结果表明,DCSD似乎比CC更安全、更有效。然而,需要更多高质量、更大样本量的RCT。