Fan Yu, Cao Dehong, Wei Qiang, Tang Zhuang, Tan Ping, Yang Lu, Liu Liangren, Liu Zhenhua, Li Xiang, Xue Wenbin
Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China.
Department of Urology, Mianyang central hospital, Mianyang, China.
Sci Rep. 2016 May 9;6:25514. doi: 10.1038/srep25514.
In situ device (ISD) and circular disposable device (CDD) are used for optimizing male circumcision (MC), but evidence to explore the characteristics of these two devices is insufficient. In order to explore this issue systematically and provide reliable evidence, ten published randomized controlled trials (RCTs) exploring the safety and efficacy of ISDs and CDDs were included (involving 4649 men). Moderate quality of the RCTs included was found after assessment. Pairwise meta-analyses and network meta-analyses were processed in stata 13.0 and AIDDS v1.16.6 respectively. According to the outcomes that were statistically significant in both pairwise and network meta-analyses, ISD was found to have less intraoperative blood loss (IB), less operative time (OT) and less incidence of wound bleeding (WB) than conventional circumcision (CC); ISD was found to have less WB but more wound healing time (WHT) than CDD; CDD was found to have less IB and less OT than CC. CDD tended to have the best wound healing condition and least pain experience; ISD tended to have the least IB, least OT, least WB, and highest satisfaction rate. With their own superiorities in many aspects, CDD and ISD are both safe and effective devices for optimizing MC.
原位装置（ISD）和环形一次性装置（CDD）用于优化男性包皮环切术（MC），但探索这两种装置特性的证据不足。为了系统地探讨这个问题并提供可靠的证据，纳入了十项已发表的随机对照试验（RCT），这些试验探索了ISD和CDD的安全性和有效性（涉及4649名男性）。评估后发现纳入的RCT质量中等。分别在Stata 13.0和AIDDS v1.16.6中进行了成对荟萃分析和网状荟萃分析。根据成对荟萃分析和网状荟萃分析中均具有统计学意义的结果，发现与传统包皮环切术（CC）相比，ISD术中失血量（IB）更少、手术时间（OT）更短、伤口出血（WB）发生率更低；发现与CDD相比，ISD的WB更少但伤口愈合时间（WHT）更长；发现CDD与CC相比，IB更少且OT更短。CDD往往具有最佳的伤口愈合情况和最少的疼痛体验；ISD往往具有最少的IB、最少的OT、最少的WB和最高的满意率。CDD和ISD在许多方面都有各自的优势，都是优化MC的安全有效的装置。
