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21世纪国民医疗服务体系中的小儿包皮环切术:英国某中心的实践概况

Pediatric Circumcision in the 21st Century National Health Service: A Snapshot of Practice in a United Kingdom Center.

作者信息

Jones Patrick, Rooney Helen, Hawary Amr

机构信息

Department of Urology, Great Western Hospital, Swindon, United Kingdom.

出版信息

Surg J (N Y). 2020 Dec 14;6(4):e188-e191. doi: 10.1055/s-0040-1721430. eCollection 2020 Oct.

Abstract

Pediatric circumcision is a commonly performed operation, yet outcomes related to procedures performed for medical indications remain underreported.  The aim of this study was to report outcomes of therapeutic circumcision from our center.  Prospective registry of elective circumcisions was maintained and analyzed at a single institution in the United Kingdom. Data collected included information on complications (early and late), emergency presentations, and referrals back from primary care services.  Between August 2015 and June 2019, 300 patients (mean age: 9 years; range: 3-16 years) underwent therapeutic circumcision. The average length of follow-up data available was 2.1 years (range: 6 months to 4 years). The overall complication rate was 4.7% (  = 16). There were no unplanned admissions and no cases returned to the operating room as emergency. Only 1% (  = 3) of patients presented with an early complication (minor bleeding, pain, urinary retention), and 3.7% (  = 11) suffered a late complication (meatal stenosis [2.7%]). All cases of meatal stenosis had lichen sclerosus confirmed on histology. Cosmetic satisfaction was 99%.  Therapeutic circumcision is an effective procedure in the pediatric population, which carries a low risk of early and late complications. Our study found that meatal stenosis only occurred in those patients with confirmed lichen sclerosus histology.

摘要

小儿包皮环切术是一种常见的手术,但因医学指征进行的手术相关结果报告仍不足。本研究的目的是报告我们中心治疗性包皮环切术的结果。在英国的一家单一机构对择期包皮环切术进行前瞻性登记和分析。收集的数据包括并发症(早期和晚期)、急诊就诊情况以及初级保健服务机构的转诊信息。2015年8月至2019年6月期间,300例患者(平均年龄:9岁;范围:3 - 16岁)接受了治疗性包皮环切术。可获得的随访数据平均时长为2.1年(范围:6个月至4年)。总体并发症发生率为4.7%(n = 16)。没有计划外入院情况,也没有病例作为急诊返回手术室。仅1%(n = 3)的患者出现早期并发症(轻微出血、疼痛、尿潴留),3.7%(n = 11)的患者出现晚期并发症(尿道口狭窄[2.7%])。所有尿道口狭窄病例经组织学证实患有硬化性苔藓。美容满意度为99%。治疗性包皮环切术在儿科人群中是一种有效的手术,早期和晚期并发症风险较低。我们的研究发现,尿道口狭窄仅发生在组织学确诊为硬化性苔藓的患者中。

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本文引用的文献

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Circumcision in the Paediatric Patient: A Review of Indications, Technique and Complications.
J Paediatr Child Health. 2018 Dec;54(12):1404. doi: 10.1111/jpc.14284.
10
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