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采用新标记技术的保留皮下组织背侧切开术:一种新型包皮环切术方法。

Subcutaneous tissue-sparing dorsal slit with new marking technique: A novel circumcision method.

作者信息

Jiang Zhao-Long, Sun Cheng-Wen, Sun Jian, Shi Gao-Feng, Li Hu

机构信息

Department of Plastic Surgery.

Department of Urology, Affiliated Hospital of Jiangnan University, Wuxi, China.

出版信息

Medicine (Baltimore). 2019 Apr;98(16):e15322. doi: 10.1097/MD.0000000000015322.

DOI:10.1097/MD.0000000000015322
PMID:31008987
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6494260/
Abstract

Circumcision is a very common surgical procedure that is performed for medical and traditional purposes in the world. However, many technical of circumcision is needed to improve. Thus, this study introduced a novel method of circumcision that is a refined version of the sleeve technique, termed subcutaneous tissue sparing dorsal slit with new marking, and evaluated the safety and efficacy of this novel method of circumcision.The randomized clinical trial included 93 adult patients with redundant foreskin or phimosis treated from May 2015 to March 2017. Patients were randomly divided into the novel circumcision method (n = 45) or conventional dissection (n = 48). The groups were compared regarding rates of intraoperative hemorrhage, operative time, pain, healing, satisfaction with penis appearance, and relevant adverse events.No patient suffered any obvious complication. Compared with the patients given conventional dissection, the patients who underwent the new surgical device experienced significantly less wound healing time, scar width, and recovery time (P <.05). The new method resulted in greater intraoperative bleeding volume and surgical time (P <.05). The rate of satisfaction with appearance of the penis was significantly higher in the group treated with the novel technique. In addition, the cost of surgery of these 2 methods was similar.Based on the above research, we found that subcutaneous tissue-sparing dorsal slit with new marking technique was an effective and safe procedure for circumcision, and deserved further application in clinical practice.

摘要

包皮环切术是一种非常常见的外科手术,在世界范围内用于医学和传统目的。然而,包皮环切术的许多技术仍有待改进。因此,本研究介绍了一种新型包皮环切术方法,它是袖套技术的改良版本,称为保留皮下组织的背侧切口并采用新标记法,并评估了这种新型包皮环切术方法的安全性和有效性。

这项随机临床试验纳入了2015年5月至2017年3月期间治疗的93例包皮过长或包茎成年患者。患者被随机分为新型包皮环切术组(n = 45)或传统切除术组(n = 48)。比较两组的术中出血率、手术时间、疼痛程度、愈合情况、对阴茎外观的满意度以及相关不良事件。

没有患者出现任何明显并发症。与接受传统切除术的患者相比,使用新手术方法的患者伤口愈合时间、瘢痕宽度和恢复时间明显更短(P <.05)。新方法导致术中出血量和手术时间增加(P <.05)。采用新技术治疗的组对阴茎外观的满意度明显更高。此外,这两种方法的手术费用相似。

基于上述研究,我们发现保留皮下组织的背侧切口并采用新标记技术是一种有效且安全的包皮环切术方法,值得在临床实践中进一步应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adde/6494260/cf9513ba529d/medi-98-e15322-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adde/6494260/cf9513ba529d/medi-98-e15322-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adde/6494260/cf9513ba529d/medi-98-e15322-g002.jpg

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本文引用的文献

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Urology. 2018 May;115:21-28. doi: 10.1016/j.urology.2018.01.022. Epub 2018 Jan 31.
2
Male circumcision for the prevention of human immunodeficiency virus (HIV) acquisition: a meta-analysis.男性割礼预防人类免疫缺陷病毒(HIV)感染:荟萃分析。
BJU Int. 2018 Apr;121(4):515-526. doi: 10.1111/bju.14102. Epub 2018 Jan 29.
3
Impact of Educational Interventions on Acceptance and Uptake of Male Circumcision in the General Population of Western China: A Multicenter Cohort Study.
教育干预对中国西部普通人群中男性割礼接受和采用的影响:一项多中心队列研究。
Sci Rep. 2017 Nov 2;7(1):14931. doi: 10.1038/s41598-017-13995-9.
4
Preventive Newborn Male Circumcision: What Is the Child's Best Interest?预防性新生儿男性包皮环切术:什么才是对孩子最有利的?
Cuad Bioet. 2017 Sep-Dec;28(94):303-316.
5
Infectious Complications of Circumcision and Their Prevention.包皮环切术的感染并发症及其预防
Eur Urol Focus. 2016 Oct;2(4):453-459. doi: 10.1016/j.euf.2016.01.013. Epub 2016 Feb 19.
6
The Effectiveness of Health Education on Maternal Anxiety, Circumcision Knowledge, and Nursing Hours: A Quasi-Experimental Study.健康教育对产妇焦虑、包皮环切术知识及护理时长的效果:一项准实验研究。
J Nurs Res. 2017 Aug;25(4):296-303. doi: 10.1097/JNR.0000000000000177.
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Circumcision and its effects in Africa.包皮环切术及其在非洲的影响。
Transl Androl Urol. 2017 Apr;6(2):149-157. doi: 10.21037/tau.2016.12.02.
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Use of a disposable circumcision suture device versus conventional circumcision: a systematic review and meta-analysis.一次性包皮环切缝合器与传统包皮环切术的应用:一项系统评价和荟萃分析。
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